Predictive and associated factors of psychiatric disorders after traumatic brain injury: a prospective study

J Neurotrauma. 2011 Jul;28(7):1155-63. doi: 10.1089/neu.2010.1528. Epub 2011 Jun 13.

Abstract

Psychiatric disorders are common and often debilitating following traumatic brain injury (TBI). However, there is little consensus within the literature regarding the risk factors for post-injury psychiatric disorders. A 1-year prospective study was conducted to examine which pre-injury, injury-related, and concurrent factors were associated with experiencing a psychiatric disorder, diagnosed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders, at 1 year post-injury. Participants were 122 adults with TBI and 88 proxy informants. Psychiatric disorders were common both pre-injury (54.1%) and at 12 months post-injury (45.9%). Results of regression analyses indicated individuals without a pre-injury psychiatric disorder or psychiatric symptomatology in the acute post-injury period were less likely to have a psychiatric disorder at 12 months post-injury. These findings confirm the importance of pre-injury history for the prediction of post-injury psychiatric disorders. Limb injury also emerged as a useful early indicator of later psychiatric disorder. Post-injury psychiatric disorders were associated with concurrent unemployment, pain, poor quality of life, and use of unproductive coping skills. The clinical implications of these findings are discussed.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Injuries / complications
  • Brain Injuries / diagnosis*
  • Brain Injuries / epidemiology*
  • Comorbidity
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neurocognitive Disorders / diagnosis*
  • Neurocognitive Disorders / epidemiology*
  • Neurocognitive Disorders / etiology
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Factors
  • Time Factors
  • Young Adult