Postconcussional syndrome Mental and Behavioural Disorders Postconcussional syndrome
Conditions
Interventions
Participants will be randomly assigned to either:
1. Immediate Treatment:
Standard CBT. This will comprise of up to a dozen one-hour sessions of therapist contact, planned to be provided over a 3 - 4
Sponsors
King's College London (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Individuals aged between 18 and 65 2. Individuals who meet criteria for post-concussional disorder (ICD-10) 3. Individuals who have had a documented head trauma leading to a probable loss or alteration of consciousness, satisfying criteria for at least a mild brain injury (American Congress of Rehabilitation Medicine [ACRM] criteria) These symptoms should have persisted for at least 6 months following the injury.
Exclusion criteria
Exclusion criteria: 1. Individuals with severe cognitive impairment (defined in this study as Mini Mental State Exam scores of less than 20 and/or Frontal Assessment Battery scores of less than 10) 2. Individuals with moderate-severe physical disability (defined in this study as Barthel score less than 15). N.B. The Barthel activities of daily living (ADL) index will not be given as a matter of routine, but only if concerns regarding prominent physical disability are noted in one of the initial assessments. 3. Individuals who have had 4 or more sessions of CBT with a clinical or counselling psychologist, or cognitive-behavioural nurse therapist, subsequent to their head injury 4. Individuals who are not fluent in English 5. Presence of other neurological disorder independent of the head injury (e.g. non-post-traumatic epilepsy) 6. Presence of drug/alcohol misuse meeting International Statistical Classification of Diseases and Related Health Problems - tenth revision (ICD-10) criteria for a dependence syndrome (F1x.2), as specified in ICD-10. However, individuals who may be using drugs or alcohol to a lesser extent, to the point of harmful use (F1x.1) will not be excluded on this criterion. 7. Where the initial assessment indicated factors such as risk of self-harm or psychosis that would necessitate the involvement of a Community Mental Health Team
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Post-concussional symptoms, as assessed using the Rivermead Post Concussion Symptoms Questionnaire (RPQ; King, Crawford, Wenden et al., 1995) 2. Quality of life, assessed using the Brain Injury Community Rehabilitation Outcome Scale (Bicro-39; Powell, Beckers and Greenwood, 1998) and an individualised measure, the Quality of Life Assessment Schedule (QOLAS; Selai, Trimble, Rossor and Harvey, 2000) | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Symptoms of anxiety and depression (The Hospital Anxiety and Depression Scales [HADS]; Zigmond and Snaith, 1983) 2. Symptoms associated with PTSD (The Impact of Events Scale - Revised [IES-R]; Weiss and Marmar, 1997) 3. Fatigue (Checklist of Individual Strength [CIS20R]; Vercoulen, Swaninck, Fennis, Galama, Van Der Meer and Bleyenberg, 1994) 4. Pain (McGill Pain Questionnaire: Melzack, 1975) 5. Anger (State-Trait Anger Expression Inventory 2 [STAXI 2]; Spielberger, 1999) 6. An additional Quality of Life measure (Visual analogue scale from EQ-5D: Rabin and de Charro, 2001) | — |
Countries
United Kingdom
Outcome results
None listed