Gould, K., Johnston, L., Ponsford, J.L., Schonberger, M. (2011). Predictive and associated factors of psychiatric disorders after traumatic brain injury: a prospective study. Journal of Neurotrauma. 28(7): 1155-63
The occurrence of psychiatric disorders following traumatic brain injury (TBI) is common and well documented in research. However, it has not been completely clear which factors are predictive of these disorders and which are simply associated with TBI. In this study 122 participants with TBI are being evaluated during their in-patient admission and 12 months post injury. The aim of this study is determine which factors, if any are predictors of psychiatric disorders 12 months post TBI and if any particular disorders are more common place than others. Participants are given structured clinical interviews consisting of the following inventories: Alcohol Use Disorders Identification Test (AUDIT), Brief Pain Inventory, Quality of Life Inventory and Coping Scale for Adults. Results show that a history of mental health counseling and unemployment are significant factors in predicting psychiatric disorders 12 months post injury. Limb injury is also a significant predictor. Disorders that are most commonly associated with post TBI are: anxiety, major depression, and bipolar disorder. TBI patients with these disorders commonly have poor coping skills, unemployment, and pain.
It’s important for therapists to be aware of any psychiatric issues their patients may have through chart reviews and speaking with hospital or facility staff. These issues can often impede treatment by decreasing session tolerance and attention leading to self-doubt or even aggression. Therapists need to be able to use clinical judgement and flexibility in using appropriate activities for when psychiatric issues are exacerbated. Most importantly therapists need to keep in mind the necessary safety measures for ensuring a safe environment.
Article:
Predictive and Associated Factors of Psychiatric Disorders after Traumatic Brain Injury: A Prospective Study
Author: Gould, Kate Rachel; Ponsford, Jennie Louise; Johnston, Lisa; Schönberger, Michael
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. [PUBLICATION ABSTRACT]
Full text: Not available.
Subject: Mental disorders; Brain damage; Head injuries; Neuropsychology; Risk factors
MeSH: Adolescent, Adult, Aged, Aged, 80 & over, Brain Injuries -- complications, Comorbidity, Delirium, Dementia, Amnestic, Cognitive Disorders -- etiology, Female, Humans, Incidence, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Risk Factors, Time Factors, Young Adult, Brain Injuries -- diagnosis (major), Brain Injuries -- epidemiology (major), Delirium, Dementia, Amnestic, Cognitive Disorders -- diagnosis (major), Delirium, Dementia, Amnestic, Cognitive Disorders -- epidemiology (major)
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