Postconcussion Syndrome: It Happens When You Think It’s Going to Be Bad

Most individuals recover completely after mild traumatic brain injury (MTBI), but symptoms persist in a “miserable minority” (postconcussion syndrome [PCS]) for unknown reasons. Hypothesizing that illness beliefs might affect outcomes, researchers evaluated 92 patients 1 to 3 weeks after admission to the emergency department with MTBI. Seventy-three patients were re-interviewed at 3 months (mean age, 42; 31 men). Evaluations covered postconcussion symptoms, post-traumatic stress symptoms, anxiety, depression, and illness perceptions, which included beliefs about TBI diagnosis, cause, duration, consequences, and effect of treatment.

At the first interview, all patients reported neurobehavioral symptoms, most commonly fatigue, headaches, and s…