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Arch Phys Med Rehabil. 2016 May;97(5):701-7. doi: 10.1016/j.apmr.2015.08.436. Epub 2015 Dec 18.

Prevalence, Risk Factors, and Correlates of Anxiety at 1 Year After Moderate to Severe Traumatic Brain Injury.

Author information

1
Moss Rehabilitation Research Institute, Elkins Park, PA. Electronic address: thart@einstein.edu.
2
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA.
3
Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA.
4
Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA.
5
Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, OH.
6
Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
7
Departments of Physical Medicine and Rehabilitation and Ophthalmology, University of Alabama at Birmingham, Birmingham, AL.
8
Veterans Administration Health Services Research and Development Center for Health Information and Communication, Indianapolis, IN; Department of Medicine, Indiana University, Indianapolis, IN; Regenstrief Institute, Inc, Indianapolis, IN.

Abstract

OBJECTIVE:

To determine at 1 year after moderate to severe traumatic brain injury the (1) rate of clinically significant anxiety; (2) rates of specific symptoms of anxiety; (3) risk factors for anxiety; and (4) associations of anxiety with other 1-year outcomes, including participation and quality of life.

DESIGN:

Prospective longitudinal observational study.

SETTING:

Inpatient rehabilitation centers, with data capture at injury and 1-year follow-up.

PARTICIPANTS:

Persons with moderate to severe traumatic brain injury who were enrolled in the Traumatic Brain Injury Model Systems database (N=1838).

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURES:

The 7-item Generalized Anxiety Disorder Scale, Patient Health Questionnaire (9-item screen for depression), FIM, Participation Assessment with Recombined Tools-Objective, and Satisfaction with Life Scale.

RESULTS:

Clinically significant anxiety was reported by 21% of the participants. Of these, >80% reported interference with daily activities, with the most common symptoms being excessive worry and irritability. A common pattern was comorbid anxiety and depression, with smaller proportions reporting either disorder alone. Anxiety had large effect sizes with respect to life satisfaction and cognitive disability and medium to small effect sizes relative to societal participation and self-care. Middle age, black race, lower socioeconomic status, preinjury mental health treatment, and at least 1 traumatic brain injury prior to the index injury were all risk factors for later anxiety.

CONCLUSIONS:

Anxiety should be screened, fully evaluated, and treated after moderate to severe traumatic brain injury. Worry and irritability might be treated with pharmacologic agents or relatively simple behavioral interventions, which should be further researched in this population.

KEYWORDS:

Anxiety; Brain injuries; Quality of Life; Rehabilitation

PMID:
26707456
DOI:
10.1016/j.apmr.2015.08.436
[Indexed for MEDLINE]

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