Association between psychiatric state and outcome following traumatic brain injury.

Abstract

OBJECTIVE: This study aimed to explore the relationship between current post-traumatic brain injury psychiatric disorders and psychosocial outcome. DESIGN: A total of 100 participants and 87 significant others were interviewed using the Structured Clinical Interview for DSM-IV Diagnosis. PARTICIPANTS: Participants with mild to very severe traumatic brain injury up to 5.5 years post-injury. METHODS: The Sydney Psychosocial Reintegration Scale assessed changes in vocational status, relationship status and independent living status. RESULTS: The vocational domain of the Sydney Psychosocial Reintegration Scale revealed the greatest degree of change. Current depression and/or anxiety contributed significantly more variance to the regression models than did any other variables. Pre-injury psychiatric disorders and substance use disorders were not predictive of any outcome variables. Longer post-traumatic amnesia duration, fewer years of education, male gender and greater time post-injury were predictive of certain outcome domains. There were no significant differences between traumatic brain injury participants' self-report and the reports of their significant others regarding psychiatric symptoms or outcome measures. CONCLUSION: The presence of current depression and anxiety are strongly related to poor outcome in terms of vocational status, relationship status and independence. The causative direction of these relationships is unclear. Using a 3-domain outcome measure has shed some light on the factors that contribute to different aspects of outcome following traumatic brain injury.