Psychiatric Outcomes after Mild Traumatic Brain Injury in Adults

Abstract

<h3>Research Objectives</h3> To enhance the knowledge regarding psychiatric outcomes after mild traumatic brain injury (mTBI) in adults, specifically considering premorbid psychiatric history. <h3>Design</h3> A retrospective observational study using a clinical dataset from the initial evaluation in clinic. Self-reported premorbid psychiatric history was determined by clinician interviews. <h3>Setting</h3> An ambulatory mTBI clinic. <h3>Participants</h3> Participants were 85 adults with mTBI confirmed by clinicians. Participants were 14 to 365 days post injury with valid psychiatric history and outcomes data. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> The Psychiatric Diagnostic Screening Questionnaire (PDSQ) was part of the clinical assessment process. The PDSQ is a brief screening measure for common psychiatric diagnoses based upon the diagnostic and statistical manual of mental disorders, 4th edition. Major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD) scales represented psychiatric outcomes. Raw scores were used as well as binary categories with scores above and below cut-off scores indicating caseness. <h3>Results</h3> There were no significant differences (p > .05) in demographic and injury characteristics (age, gender, race, loss of consciousness, and days since injury) by psychiatric history status (yes/no) with exception of year of education (p= .025). On average, participants were 36.6 years old with 13.8 years of education. Men (47.6%) and women (52.4%) were fairly even in representation. Most participants were Caucasian (89.4%). Individuals with premorbid psychiatric histories had greater symptoms of GAD (F(1, 76)= 11.90, p=.001, partial eta squared=0.14), MDD (F(1, 76)= 4.62, p=.035, partial eta squared=0.06), and PTSD (F(1, 76)= 6.54, p=.013, partial eta squared=0.08). When considering scores above respective cut-offs for each outcome, similar findings were revealed. Of note, the Odds Ratio for positive screens on depression was 7.08 (p < .001), and it was 5.45 (p= .002) for anxiety, among those with a premorbid psychiatric history. There was no association with PTSD screening and premorbid psychiatric history (p= .083). <h3>Conclusions</h3> Premorbid psychiatric history is demonstrably associated with worse psychiatric outcomes after mTBI in adults, particularly for anxiety and depression outcomes. <h3>Author(s) Disclosures</h3> None.