Canadian study: Teens who have suffered a concussion at higher risk for bullying and suicide

16 Apr

Kids Health has some great information about concussions at their site:

What Is a Concussion and What Causes It?
The brain is made of soft tissue and is cushioned by spinal fluid. It is encased in the hard, protective skull. When a person gets a head injury, the brain can move around inside the skull and even bang against it. This can lead to bruising of the brain, tearing of blood vessels, and injury to the nerves. When this happens, a person can get a concussion — a temporary loss of normal brain function.
Most people with concussions recover just fine with appropriate treatment. But it’s important to take proper steps if you suspect a concussion because it can be serious.
Concussions and other brain injuries are fairly common. About every 21 seconds, someone in the United States has a serious brain injury. One of the most common reasons people get concussions is through a sports injury. High-contact sports such as football, boxing, and hockey pose a higher risk of head injury, even with the use of protective headgear.
People can also get concussions from falls, car accidents, bike and blading mishaps, and physical violence, such as fighting. Guys are more likely to get concussions than girls. However, in certain sports, like soccer, girls have a higher potential for concussion.
http://kidshealth.org/teen/safety/first_aid/concussions.html#a_What_Is_a_Concussion_and_What_Causes_It_
https://drwilda.com/2012/03/06/dont-ignore-concussions/
See, Update: Don’t ignore concussions https://drwilda.com/2012/05/20/update-dont-ignore-concussions/

Bryan Toporek reported in the Education Week article, Once-Concussed Teenagers Found to Be at Higher Risk for Bullying, Suicide:

Teenagers who have suffered a traumatic brain injury such as a concussion are twice as likely to be bullied and roughly three times as likely to attempt suicide compared to those who haven’t, according to a new study published online today in the open-access journal PLOS ONE.
The study drew upon data from the 2011 Ontario Student Drug Use and Health Survey, which contains responses from nearly 9,300 students between grades 7 and 12 in 181 publicly funded schools across Ontario. Questions about traumatic brain injuries were added to the OSDUHS for the first time in 2011 and were answered by a subsample of 4,816 students.
The teenagers were asked whether they had ever suffered a head injury that resulted in them being unconscious for at least five minutes or required at least one night’s stay in a hospital. Just under 20 percent of the students involved in the study had suffered at least one head injury that met either of those qualifications….
http://blogs.edweek.org/edweek/schooled_in_sports/2014/04/once-concussed_teenagers_found_to_be_at_higher_risk_for_bullying_suicide.html

Citation:

Research Article
Suicidality, Bullying and Other Conduct and Mental Health Correlates of Traumatic Brain Injury in Adolescents
Gabriela Ilie mail,
Robert E. Mann,
Angela Boak,
Edward M. Adlaf,
Hayley Hamilton,
Mark Asbridge,
Jürgen Rehm,
Michael D. Cusimano
Published: April 15, 2014
•DOI: 10.1371/journal.pone.0094936

Objective
Our knowledge on the adverse correlates of traumatic brain injuries (TBI), including non-hospitalized cases, among adolescents is limited to case studies. We report lifetime TBI and adverse mental health and conduct behaviours associated with TBI among adolescents from a population-based sample in Ontario.
Method and Findings
Data were derived from 4,685 surveys administered to adolescents in grades 7 through 12 as part of the 2011 population-based cross-sectional Ontario Student Drug Use and Health Survey (OSDUHS). Lifetime TBI was defined as head injury that resulted in being unconscious for at least 5 minutes or being retained in the hospital for at least one night, and was reported by 19.5% (95%CI:17.3,21.9) of students. When holding constant sex, grade, and complex sample design, students with TBI had significantly greater odds of reporting elevated psychological distress (AOR = 1.52), attempting suicide (AOR = 3.39), seeking counselling through a crisis help-line (AOR = 2.10), and being prescribed medication for anxiety, depression, or both (AOR = 2.45). Moreover, students with TBI had higher odds of being victimized through bullying at school (AOR = 1.70), being cyber-bullied (AOR = 2.05), and being threatened with a weapon at school (AOR = 2.90), compared with students who did not report TBI. Students with TBI also had higher odds of victimizing others and engaging in numerous violent as well as nonviolent conduct behaviours.
Conclusions
Significant associations between TBI and adverse internalizing and externalizing behaviours were found in this large population-based study of adolescents. Those who reported lifetime TBI were at a high risk for experiencing mental and physical health harms in the past year than peers who never had a head injury. Primary physicians should be vigilant and screen for potential mental heath and behavioural harms in adolescent patients with TBI. Efforts to prevent TBI during adolescence and intervene at an early stage may reduce injuries and comorbid problems in this age group…. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0094936
Here is the press release from St. Michael’s Hospital:
Teenagers who have had a concussion also have higher rates of suicide attempts, being bullied and high-risk behavior, study finds
Toronto, April 15, 2014
Teenagers who have suffered a traumatic brain injury such as a concussion are at “significantly greater odds” of attempting suicide, being bullied and engaging in a variety of high risk behaviours, a new study has found.
They are also more likely to become bullies themselves, to have sought counselling through a crisis help-line or to have been prescribed medication for anxiety, depression or both, said Dr. Gabriela Ilie, lead author of the study and a post-doctoral fellow at St. Michael’s Hospital.
They have higher odds of damaging property, breaking and entering, taking a car without permission, selling marijuana or hashish, running away from home, setting a fire, getting into a fight at school or carrying or being threatened by a weapon, she said in a paper published today in the journal PLOS ONE.
Dr. Ilie said the study provides the first population-based evidence demonstrating the extent of the association between TBI and poor mental health outcomes among adolescents.
“These results show that preventable brain injuries and mental health and behavioural problems among teens continue to remain a blind spot in our culture,” Dr. Ilie said. “These kids are falling through the cracks.”
The data used in the study was from the 2011 Ontario Student Drug Use and Health Survey developed by the Centre for Addiction and Mental Health. The survey, one of the longest ongoing school surveys in the world, contains responses from almost 9,000 students from Grades 7-12 in publicly funded schools across Ontario. The OSDUHS began as a drug use survey, but is now a broader study of adolescent health and well-being. Questions about traumatic brain injury were added to the survey for the first time in 2011.
“We know from a previous study based on OSDUHS data that as many as 20 per cent of adolescents in Ontario said they have experienced a traumatic brain injury in their lifetime,” said Dr. Robert Mann, senior scientist at CAMH and director of the OSDUHS. “The relationship between TBI and mental health issues is concerning and calls for greater focus on prevention and further research on this issue.”
Dr. Ilie said the teenage years are already a turbulent time for some, as they try to figure out who they are and what they want to be. Since a TBI can exacerbate mental health and behavioural issues, she said primary physicians, schools, parents and coaches need to be vigilant in monitoring adolescents with TBI.
In addition, she said many TBI experienced by youth occur during sports and recreational pursuits, and are largely preventable through use of helmets and the elimination of body checking in hockey.
The study found that adolescents who had suffered a TBI sometime in their life had twice the odds of being bullied at school or via the Internet and almost three times the odds of attempting suicide or being threatened at school with a weapon compared to those without a TBI.
This research was funded by a Canadian Institute of Health Research Team Grant in Traumatic Brain Injury and Violence and by the Ontario Neurotrauma Foundation. Additional funding was obtained from a grant from AUTO21, a member of the Networks of Centres of Excellence program that is administered and funded by the Natural Sciences and Engineering Research Council, the Social Sciences and Humanities Research Council, in partnership with Industry Canada, and ongoing funding support from the Ontario Ministry of Health and Long-Term Care.
About St. Michael’s Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
Media contacts
For more information, or to arrange an interview with Dr. Sievenpiper, contact:
Leslie Shepherd
Manager, Media Strategy
416-864-6094
shepherdl@smh.ca
About CAMH
The Centre for Addiction and Mental Health (CAMH) is Canada’s largest mental health and addiction teaching hospital, as well as one of the world’s leading research centres in its field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit http://www.camh.ca.
For more information on OSDUHS or to interview Dr. Mann, please contact:
Kate Richards
Media Relations
Centre for Addiction and Mental Health (CAMH)
Office: 416 535 8501 x36015
Mobile: 416 427 7743
kate.richards@camh.ca
http://www.camh.ca

The Sports Concussion Institute has some great information about concussions http://www.concussiontreatment.com/concussionfacts.html

People must take concussions very seriously.

Resources:

Concussions
http://kidshealth.org/teen/safety/first_aid/concussions.html#a_What_Is_a_Concussion_and_What_Causes_It_

Concussion http://www.emedicinehealth.com/concussion/article_em.htm

Concussion – Overview http://www.webmd.com/brain/tc/traumatic-brain-injury-concussion-overview

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