Special Invited Article Concussion, Sports and Psychiatry

Background: Concussions (also known as mild traumatic brain injuries, MTBI) are common among adolescents, especially those who play sports. While often considered non-serious injuries, they can result in significant impairment in functioning. Neuropsychiatric symptoms, including cognitive impairment, behavioral dysfunction, and psychiatric disorders are among the most common sequelae. Method: This article presents an overview of what is known at this point and makes recommendations regarding assessment and management. Results: The knowledge base has expanded rapidly concerning risk factors, sequelae and neurobiology of MTBI. It is still underdeveloped regarding treatment, especially with regard to adolescents. Nonetheless, it is possible to extrapolate from the research on adults to develop a rational approach to management. Conclusions: Key aspects of management include education and support for patients and families, teaching coping skills, and making academic accommodations. There is a limited role for psychopharmacologic approaches in conjunction with a comprehensive multidisciplinary approach. Most patients will recover but treatment must be individualized to address the patient’s specific problems and concerns.