COGNITIVE-BEHAVIORAL PREVENTION OF POSTCONCUSSION SYNDROME

The symptoms of postconcussion syndrome (PCS) are persistent, and no e mpirically tested treatment is available. The treatment group (n = 29) in this study received a printed manual and met with a therapist prio r to hospital discharge to review the nature and incidence of expected symptoms, the cognitive-behavioral model of symptom maintenance and t reatment techniques for reducing symptoms, and instructions for gradua l resumption of premorbid activities. The control group (n = 29) recei ved routine hospital treatment and discharge instructions. Both groups had sustained mild head injuries characterized by Glascow Coma Scale scores of 13-15 on admission without any measurable period of posttrau matic amnesia. Group assignment was random Groups did not differ signi ficantly on age, Glascow scores, litigation status, gender or initial number of PCS symptoms. Patients were contacted 6 months following inj ury by an interviewer who was unaware of group assignment to obtain ou tcome data. Treated patients reported significantly shorter average sy mptom duration (33 vs. 51 days) and significantly fewer of the 12 symp toms at followup (1.6 vs. 3.1). Subjects were also asked how often eac h symptom had occurred in the previous week, and how severe the sympto m typically was. The treatment group experienced significantly fewer s ymptomatic days (.5 vs. 1.3) and lower mean severity levels. Results s uggest that brief early psychological intervention can reduce the inci dence of PCS.