A System-wide Retrospective Cohort Analysis of the Development of Psychiatric Conditions Following Concussion (P7-1.005)

Abstract

<h3>Objective:</h3> To determine if mTBI is a risk factor for the development of major depressive disorder and/or general anxiety disorder within one year of injury. <h3>Background:</h3> Minor traumatic brain injury (mTBI; concussion) commonly presents to the health care system. While most mTBI cases recover with complete return to baseline, there are individuals who have persistent symptoms or develop new disorders following brain injury. Despite findings linking psychiatric disorders to traumatic brain injuries, identifying similar pathologies post-mTBI has been lacking until now. <h3>Design/Methods:</h3> An observational, retrospective cohort study of all male and female patients with diagnosed mTBI (concussion) who received care within the Ochsner Health system between January 1, 2010 and December 31, 2020. Relative risk &gt;2.0 was recognized as significant. <h3>Results:</h3> Of the 10,637 mTBI patients presenting over the 10-year period, 7,940 met the inclusion criteria for congruent comparison to National Institute of Mental Health data. Forty-five percent of patients were aged 18–29, 19% were aged 30–44, 16% were aged 45–59, and 20% were older than 60. Gender was also evaluated among the study population – females represented 54.6%, while men made up 45.4%. Across all ages, mTBI within one year increased the risk of GAD development a factor of 2.5. Patients older than 59 years were at nearly four times greater risk of developing GAD. Although males showed lower prevalence of GAD than females, patients with mTBI were twice as likely to develop GAD irrespective of gender. <h3>Conclusions:</h3> Adult patients suffering mTBI demonstrated significant risk of GAD among the total study population, particularly young adults and those of advanced age. Further nuanced evaluation is necessary before development of specific guidelines to protect vulnerable patients. Future work requires greater ethnic diversity, socioeconomic background, and participants of adolescent age. In order to prevent progression to mental health disorders, systematic guidelines should be in place for patient support. <b>Disclosure:</b> Mr. Brown has nothing to disclose. Mr. Kazmer has nothing to disclose. Dr. Posas has nothing to disclose.