Article Text

Download PDFPDF
Illness perceptions and outcome in mild head injury: a longitudinal study
  1. Robert Whittaker1,
  2. Steven Kemp2,
  3. Allan House3
  1. 1Department of Clinical Health Psychology, Bradford Teaching Hospitals Foundation Trust, St Luke’s Hospital, Bradford, UK
  2. 2St James’s University Hospital, Leeds, UK
  3. 3Institute of Health Sciences and Public Health Research, Head, Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK
  1. Correspondence to:
 Dr Robert Whittaker
 Department of Clinical Health Psychology, Bradford Teaching Hospitals Foundation Trust, St Luke’s Hospital, Little Horton Lane, Bradford, West Yorkshire BD5 0NA, UK; robert.whittaker{at}


Background: A range of neuropathological and psychosocial factors have been implicated in the aetiology and maintenance of post-concussional syndrome (PCS), with a growing consensus in the literature that this is a complex, multifactorial condition. The role of patients’ perceptions in PCS has not been examined to date.

Objective: This longitudinal study examines the role of illness perceptions in predicting outcome following mild head injury, controlling for severity of injury, post-traumatic stress symptoms, anxiety and depression, using a logistic regression analysis.

Method: 73 patients were admitted to an accident and emergency department with mild head injury (Glasgow Coma Scale score 13–15; loss of consciousness <20 min; post-traumatic amnesia <24 h). Data on PCS symptomatology, illness perceptions, post-traumatic stress symptoms, anxiety and depression were collected after the injury and at the 3 month follow-up. Logistic regression analysis was used to evaluate predictors of outcome.

Results: Following a mild head injury, symptomatic patients who believe that their symptoms have serious negative consequences on their lives and will continue to do so, are at heightened risk of experiencing significant enduring post-concussional symptoms (p<0.001). Adding measures of severity of injury, post-traumatic stress symptoms, anxiety and depression to the regression model did not improve prediction of outcome.

Conclusion: Whatever other physical or psychological factors may be involved, patients’ perceptions of their illness early after head injury play a part in the persistence of PCS.

  • HADS, Hospital Anxiety and Depression Scale
  • IES, Impact of Event Scale
  • IPQ-R, Illness Perception Questionnaire-Revised
  • PCS, post-concussional syndrome
  • RPQ, Rivermead Post-concussion Questionnaire

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: None.

Linked Articles