{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T02:25:17Z","timestamp":1787970317354,"version":"build-2784847793"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,12]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to determine whether adolescent traumatic brain injury (TBI) is associated with long-term risk of depression, anxiety, suicide ideation, suicide attempt, and substance use disorders, and whether these risks differ by sex and injury severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This retrospective cohort study used electronic health record data from January 1, 2000, to January 1, 2019, with a 5-year follow-up period. Data were obtained from the TriNetX platform, which aggregates deidentified information from 60 US healthcare organizations across all 50 states. A total of 262,262 adolescents aged 10\u201318 years diagnosed with mild or moderate to severe TBI were included. Cohorts were stratified by sex and TBI severity and matched to controls without TBI by race, socioeconomic factors, and prior psychiatric or head injury diagnoses. Exposures were defined by ICD-10 codes for TBI severity, and outcomes included incidence of depression, anxiety, alcohol dependence, nicotine dependence, suicide ideation, and suicide attempt within 5 years of TBI diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 262,262 adolescents with TBI (154,149 male and 108,113 female), mild TBI was associated with increased risk of depression, anxiety, suicide ideation, suicide attempt, alcohol dependence, and nicotine dependence in both males and females compared with matched controls. Females with mild TBI had a higher risk of mood disorders and suicidality, whereas males had higher risk of substance use. Moderate to severe TBI was not associated with higher risk for these disorders compared with mild TBI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Adolescent TBI, regardless of severity, was associated with increased risk of psychiatric disorders and substance use, with females showing greater vulnerability to mood disorders and suicidality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.2.peds25597","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:41Z","timestamp":1781049641000},"page":"1-7","source":"Crossref","is-referenced-by-count":0,"title":["Risk of mood, anxiety, and substance use disorders following adolescent traumatic brain injury: a retrospective cohort study"],"prefix":"10.3171","author":[{"given":"Austin A.","family":"Kennemer","sequence":"first","affiliation":[{"name":"Case Western Reserve University School of Medicine, Cleveland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aritra","family":"Nag","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine, Cleveland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun S.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University Hospitals, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University Hospitals, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"10","key":"b1","series-title":"BMJ Open","first-page":"e075049","article-title":"Global, regional and national burden of traumatic brain injury and spinal cord injury, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"13","author":"Guan B","year":"2023","unstructured":"Guan B, Anderson DB, Chen L, Feng S, Zhou H. Global, regional and national burden of traumatic brain injury and spinal cord injury, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019. BMJ Open. 2023;13(10):e075049. doi:10.1136\/bmjopen-2023-075049"},{"key":"b2","series-title":"World Neurosurg","first-page":"82","article-title":"A narrative review on financial challenges and health care costs associated with traumatic brain injury in the United States","volume":"187","author":"Valentim W","year":"2024","unstructured":"Valentim W, Bertani R, Brasil S. A narrative review on financial challenges and health care costs associated with traumatic brain injury in the United States. World Neurosurg. 2024;187:82\u201392. doi:10.1016\/j.wneu.2024.03.175"},{"issue":"5","key":"b3","series-title":"Med Care","first-page":"451","article-title":"Costs of nonfatal traumatic brain injury in the United States, 2016","volume":"59","author":"Miller GF","year":"2021","unstructured":"Miller GF, DePadilla L, Xu L. Costs of nonfatal traumatic brain injury in the United States, 2016. Med Care. 2021;59(5):451\u2013455. doi:10.1097\/MLR.0000000000001511"},{"issue":"11","key":"b4","series-title":"Lancet Neurol","first-page":"1004","article-title":"Traumatic brain injury: progress and challenges in prevention, clinical care, and research","volume":"21","author":"Maas AIR","year":"2022","unstructured":"Maas AIR, Menon DK, Manley GT,  Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurol. 2022;21(11):1004\u20131060. doi:10.1016\/S1474-4422(22)00309-X"},{"issue":"27","key":"b5","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"549","article-title":"Centers for Disease Control and Prevention (CDC). CDC grand rounds: reducing severe traumatic brain injury in the United States","volume":"62","year":"2013","unstructured":"Centers for Disease Control and Prevention (CDC). CDC grand rounds: reducing severe traumatic brain injury in the United States. 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Crit Care. 2016;20(1):148. doi:10.1186\/s13054-016-1318-1"},{"issue":"2","key":"b10","series-title":"World Psychiatry","first-page":"203","article-title":"Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention","volume":"22","author":"Volkow ND","year":"2023","unstructured":"Volkow ND, Blanco C. Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention. World Psychiatry. 2023;22(2):203\u2013229. doi:10.1002\/wps.21073"},{"issue":"1","key":"b11","series-title":"Acta Neuropathol","first-page":"91","article-title":"Neuropathology of substance use disorders","volume":"127","author":"Cadet JL","year":"2014","unstructured":"Cadet JL, Bisagno V, Milroy CM. Neuropathology of substance use disorders. 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