Skip to main content
×
×
Home

The Postconcussional Syndrome: Social Antecedents and Psychological Sequelae

  • George Fenton (a1), Roy McClelland (a2), Anne Montgomery (a3), Geraldine MacFlynn (a4) and William Rutherford...
Abstract

The study consisted of a prospective investigation of 45 consecutively admitted patients who had sustained a mild head injury. In all cases the duration of post-traumatic amnesia was less than 24 hours. Head injury patients had an average of three adverse life events in the year preceding injury compared with 1.5 for controls. Using the PSE, 39% of the group were diagnosed psychiatric cases at six weeks after the injury. For cases the mean level of chronic social difficulties (3.3) was four times that for non-cases (0.8). Six months after injury, 28% of the head injury group had three or more symptoms. These chronic cases were on average ten years older than those whose symptoms had remitted. Chronic cases had, on average, three social difficulties, twice as many as found among those whose symptoms had remitted. The emergence and persistence of the postconcussional syndrome are associated with social adversity before the accident. While young men are most at risk of minor head injury, older women are most at risk of chronic sequelae.

Copyright
Corresponding author
Correspondence
References
Hide All
Barth, J. T., Alves, W. M., Ryan, T. V., et al (1989) Mild head injury in sports: neuropsychological sequelae and recovery of function. In Mild Head Injury (eds Levin, H. S., Elsenberg, H. M. & Benton, A. L.). Oxford: Oxford University Press.
British Medical Journal (1961) Accident neurosis. British Medical Journal, i, 10181019.
Brooks, N. (1984) Closed Head Injury, Psychological, Social and Family Consequences. Oxford: Oxford University Press.
Brown, G. W. & Davidson, S. (1978) Social class, psychiatric disorder, and accidents to children. Lancet, i, 378381.
Brown, G. W. & Harris, T. O. (1978) Social Origins of Depression. London: Tavistock.
Cairns, E., Wilson, R., McClelland, R., et al (1990) Improving the validity of the GHQ30 by rescoring for chronicity: a failure to replicate. Journal of Clinical Psychology, 45, 793798.
Casson, I. R., Seigel, O., Campbell, E. A., et al (1984) Brain damage in modern boxers. Journal of the American Medical Association, 251, 26632667.
Cartlidge, N. E. F. & Shaw, D. A. (1981) Head Injury. London: Saunders.
Greenwood, M. & Woods, H. M. (1919) Preliminary Report on Special Tests. Sacramento, California: Dept of Motor Vehicles.
Gronwall, D. & Wrightson, P. (1974) Delayed recovery of intellectual function after minor head injury. Lancet, ii, 605609.
Gronwall, D. & Wrightson, P. (1975) Cummulative effect of concussion. Lancet, ii, 995997.
Henderson, S., Byrne, D. G. & Duncan Jones, P. (1981) Neuroses and the Social Environment. London: Academic Press.
Katz, M. M. & Lyerly, S. B. (1963) Methods for assessing adjustment and social behaviour in the community, 1. Rationale, descriptions, discriminative validity and scale development. Psychological Reports, 13, 503535.
Levin, H. S., Mattis, S., Raff, R. M., et al (1987) Neuro–behavioural outcome following minor head injury: a three centre study. Journal of Neurosurgery, 66, 234243.
Lidvall, H. F., Linderoth, B. & Norlin, B. (1974) Causes of the post–concussional syndrome. Acta Neurologica Scandinavica (suppl. 56), 1144.
Lishman, W. A. (1988) Physiogenesis and psychogenesis in the post–concussional syndrome. British Journal of Psychiatry, 153, 460469.
MacFlynn, G., Montgomery, E. A., Fenton, G. W., et al (1984) Measurement of reaction time following minor head injury. Journal of Neurology, Neurosurgery and Psychiatry, 47, 13261331.
Millar, H. C. (1961) Accident neurosis. British Medical Journal, i, 919925, 992–998.
Montgomery, A., Fenton, G. W. & McClelland, R. J. (1984) Delayed brainstem conduction time in post–concussional syndrome. Lancet, i, 1011.
Montgomery, A., Fenton, G. W. & McClelland, R. J., et al (1991) The psychobiology of minor head injury. Psychological Medicine, 21, 375384.
Rimel, R. W., Giordani, B., Barth, J. T., et al (1981) Disability caused by minor head injury. Neurosurgery, 9, 221228.
Russell, W. R. (1974) Recovery after minor head injury. Lancet, ii, 1315.
Rutherford, W. H., Merrett, J. D. & McDonald, J. R. (1977) Sequelae of concussion caused by minor head injuries. Lancet, i, 14.
Rutherford, W. H., Merrett, J. D. & McDonald, J. R. (1978) Symptoms at one year following concussion from minor head injury. Injury, 10, 225230.
Selzer, M., Rogers, J. & Kern, S. (1968) Fatal accidents: the role of psychopathology, social stress and acute disturbance. American Journal of Psychiatry, 124, 10281036.
Taylor, A. R. & Bell, T. K. (1966) Slowing of cerebral circulation after concussional head injury. Lancet, ii, 178180.
Watson, M. R., Fenton, G. W., McClelland, R. J., et al (1993) The post–concussional state revisited. British Journal of Psychiatry, (in press).
Whitlock, F. A., Stroll, J. R. & Rekhdahal, R. J. (1977) Psychiatric epidemiology, its uses and limitations. Australian and New Zealand Journal of Psychiatry, 11, 127132.
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.
Wing, J. K., & Sturt, E. (1978) The PSE–ID-CATEGO System: A Supplementary Manual (Mimeo). London: Institute of Psychiatry.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

The Postconcussional Syndrome: Social Antecedents and Psychological Sequelae

  • George Fenton (a1), Roy McClelland (a2), Anne Montgomery (a3), Geraldine MacFlynn (a4) and William Rutherford...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *