Abstract
Traumatic brain injury is (TBI) a leading cause of morbidity and mortality in youth. Adult survivors of a severe pediatric TBI are vulnerable to global impairments, including greater employment difficulties, poor quality of life (HRQoL) and increased risk of mental health problems. When estimating the health related quality of life in adolescents, the presence of anxiety and depression and the quality of social relationships are important considerations, because adolescents are entrenched in social development during this phase of maturation. The influence of anxiety, depression and loneliness on health related quality of life in adolescent survivors of TBI has not been documented. This pilot study aimed to identify and measure the relationship between anxiety, depression and loneliness and perceived health related quality of life in adolescent survivors of a TBI. Method: mixed method/cohort pilot study (11 adolescents, mild to severe TBI; 9 parents), using self-report and proxy-report measures of anxiety, depression, health related quality of life, loneliness and clinical psychiatric interviews (adolescent only). Results: Self-reported depression was significantly correlated with self-reported HRQoL (rs [11] = −0.88, p<0.001). Age at injury was significantly correlated with self-reported HRQoL (rs [11] = −0.68, p = 0.02). Self-reported depression predicted self-reported HRQoL (R2 = 0.79, F [1, 10] = 33.48, p<0.001), but age at injury did not (R2 = 0.19, F [1, 10] = 2.09, p = 0.18). Conclusions: Our results suggest that depression is a predictor of health related quality of life in youth post-TBI. The possibility of using targeted assessment and therapy for depression post-TBI to improve health related quality of life should be explored.
Highlights
Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children and adolescents in first world nations [1]
In recent years there has been a move towards assessing sequelae of TBI beyond cognitive domains, including quality of life (HRQoL) and mood disorders, such as ADHD, depression and anxiety post-injury [2]
Research from our team investigating adult survivors of pediatric TBI has reported that survivors of severe TBI are vulnerable to global functional impairments, including poorer school performance, greater employment difficulties, poor HRQoL and increased risk of mental health problems [3]
Summary
Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children and adolescents in first world nations [1]. In recent years there has been a move towards assessing sequelae of TBI beyond cognitive domains, including quality of life (HRQoL) and mood disorders, such as ADHD, depression and anxiety post-injury [2]. Research from our team investigating adult survivors of pediatric TBI has reported that survivors of severe TBI are vulnerable to global functional impairments, including poorer school performance, greater employment difficulties, poor HRQoL and increased risk of mental health problems [3]. The appropriateness of proxy reporting for internalizing conditions, such as quality of life (QoL), depression and anxiety has been criticized for many years in the broader psychology literature [4,5], yet parental proxy reporting remains the most often used method of assessment for these states in the pediatric TBI field [6]. There is a strong co morbidity between depression and anxiety, with reported co morbidity as high as 90% in those with an already diagnosed anxiety disorder experiencing a concurrent depressive episode [9]
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