Affiliation:
La Trobe University
Short bio:
Simon Crowe is Adjunct Professor and Chair of the Academic Board of the Cairnmillar Institute and Emeritus Professor of Neuroscience and Clinical Neuropsychology at La Trobe University. He is the President of the ICP 2028 to be held in Melbourne, Australia. Professor Crowe is the inaugural Chair of the Asia Pacific Psychology Alliance. He is the past Chair of the College of Clinical Neuropsychologists of the Australian Psychological Society (2013-2018). He is also past Chair of the Australian Psychology Accreditation Council (2016-2018). He is a past President of the Australian Psychological Society (APS: 2010-2012). He is an Honorary Fellow of the APS, and a Fellow of the National Academy of Neuropsychology (US), the Association for Psychological Science and the Australian Institute of Company Directors. He is a member of the APS Colleges of Clinical Psychology, Clinical Neuropsychology and Forensic psychology and has area of practice endorsement in each of these areas. He is a past editor of the Journal, Australian Psychologist (2001-2005). Professor Crowe was also President of the Alcohol Related Brain Injury Assessment and Support Service (ARBIAS) from 1994-1999, and was made a Life member of ARBIAS in 2000. Professor Crowe maintains strong research programs into the neuropsychology of neuropsychiatric disorders and a variety of neuropsychological assessment issues. He has published three monographs, more than 150 refereed journal articles and numerous book chapters, conference presentations, notes and commentaries. He has supervised more than 40 doctoral degree candidates (PhD and DPsych) as well as numerous Masters and fourth year theses. He continues to conduct and extensive practice in the area of medico-legal disputation and is an independent neuropsychological examiner for the Victorian Workcover Authority, Corrections Victoria, the Children’s Court Clinic and the Transport Accident Commission in Victoria.
Title:
The vexed issue of protracted cognitive, somatic and emotional complaints following mild traumatic brain injury.
Abstract:
The reported cognitive, somatic and emotional symptoms which sometimes persist following a mild traumatic brain injury (mTBI) have been referred to as “postconcussion syndrome (PCS)” in the International Statistical Classification of Diseases and Related Health Problems (ICD-10), as “postconcussional disorder (PCD)” in the Diagnostic and Statistical Manual of Mental Disorders (4th edition, DSM-IV), and as “persistent symptoms” post mTBI by other authors. However, t this point in time, neither the World Health Organization (WHO), nor the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) contains a specific entry for the condition, post-concussion syndrome. Post concussion syndrome (PCS) describes a constellation of symptoms that commonly occur following mild traumatic brain injury (mTBI) with the term persisting PCS being employed when the condition continues beyond 3 months post injury. This paper examines the issue of the existence of PCS as a discrete diagnostic clinical entity examining the issue from the converging perspectives of problems with the diagnostic formulation of the condition, issues associated with self-reports as data concerning this entity, the persistence of psychometrically demonstrable cognitive deficit following mTBI, the degree to which other entities including pain, sleep disorders, depression and anxiety may be conflated with the condition, the vexed problem of performance and symptom validity in this group of patients and the implications of each of these issues to treatment and the ultimate resolution of the condition going forward. On balance, it can now legitimately be said that the diagnosis of this “condition” is no longer clinically useful and suggestions of a more diagnostically and methodologically sound characterisation of this presentation is desperately needed in the interests of better management of these patients therapeutically, in terms of health system economy and in terms of the medico-legal disputation surrounding this controversial entity.