Summary: Cognitive-behavioral therapy (CBT) delivered soon after mTBI may be effective for reducing PCS. Twenty-eight patients with uncomplicated mTBI at risk for chronic PCS, based on a published algorithm, were enrolled within 6 weeks post-injury in an open-label, parallel-group, randomized controlled trial, with masked outcome assessment 3 months after enrolment. Interventions were (1) treatment as usual (education, reassurance, and symptom management strategies) from an occupational therapist, or (2) treatment as usual plus CBT delivered by a psychologist. Outcomes were assessed with the Rivermead Postconcussion Symptoms Questionnaire. Treatment effect sizes were moderate for postconcussion symptoms (Cohen d = 0.74) and moderate-large for most secondary outcome measures (Cohen d=0.62-1.61). Fewer participants receiving CBT had a diagnosis of PCS at follow-up (54% vs 91%, P < .05).
Cognitive-Behavioral Prevention of Postconcussion Syndrome in At-Risk Patients: A Pilot Randomized Controlled Trail
Citation: Silverberg, ND, Hallam, BJ, Rose, A, Underwood, H, Whitfield, K, Thornton, AE , Whittal, ML. 2013. Cognitive-Behavioral Prevention of Postconcussion Syndrome in At-Risk Patients: A Pilot Randomized Controlled Trial. J Head Trauma Rehabil