Factors associated with posttraumatic stress disorder following moderate to severe traumatic brain injury: a prospective study

Yvette Alway, Adam McKay, Kate Rachel Gould, Lisa Susan Johnston, Jennie Ponsford

Research output: Contribution to journalArticleResearchpeer-review

14 Citations (Scopus)

Abstract

Background: This study prospectively examined the relationship between preinjury, injury-related, and postinjury factors and posttraumatic stress disorder (PTSD) following moderate to severe traumatic brain injury (TBI). Method: Two hundred and three participants were recruited during inpatient admission following moderate to severe TBI. Participants completed an initial assessment soon after injury and were reassessed at 3, 6, and 12 months, 2, 3, 4, and 5 years postinjury. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-fourth edition was used to diagnose pre- and postinjury PTSD and other psychiatric disorders. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Inventory (QOLI) were used to evaluate functional and psychosocial outcome from 6 months postinjury. Results: The frequency of PTSD ranged between 0.5 and 9.4 during the 5-year period, increasing throughout the first 12 months and declining thereafter. After controlling for other predictors, shorter posttraumatic amnesia duration (odds ratio = 0.96, 95 CI = 0.92-1.00), other concurrent psychiatric disorder (odds ratio = 14.22, 95 CI = 2.68-75.38), and lower GOSE (odds ratio = 0.38, 95 CI = 0.20-0.72) and QOLI scores (odds ratio = 0.97, 95 CI = 0.95-0.97) were associated with greater odds of having injury-related PTSD. Discussion: The results of this study indicate that while shorter posttraumatic amnesia duration is associated with PTSD, greater TBI severity does not prevent PTSD from evolving. Patients with PTSD experienced high rates of psychiatric comorbidity and poorer functional and quality of life outcomes after TBI. Conclusion: There is a need to direct clinical attention to early identification and treatment of PTSD following TBI to improve outcomes
Original languageEnglish
Pages (from-to)19-26
Number of pages8
JournalDepression and Anxiety
Volume33
Issue number1
DOIs
Publication statusPublished - 1 Jan 2016

Keywords

  • traumatic brain injury
  • anxiety disorder
  • Posttraumatic stress disorder
  • quality of life
  • Rehabilitation

Cite this

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title = "Factors associated with posttraumatic stress disorder following moderate to severe traumatic brain injury: a prospective study",
abstract = "Background: This study prospectively examined the relationship between preinjury, injury-related, and postinjury factors and posttraumatic stress disorder (PTSD) following moderate to severe traumatic brain injury (TBI). Method: Two hundred and three participants were recruited during inpatient admission following moderate to severe TBI. Participants completed an initial assessment soon after injury and were reassessed at 3, 6, and 12 months, 2, 3, 4, and 5 years postinjury. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-fourth edition was used to diagnose pre- and postinjury PTSD and other psychiatric disorders. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Inventory (QOLI) were used to evaluate functional and psychosocial outcome from 6 months postinjury. Results: The frequency of PTSD ranged between 0.5 and 9.4 during the 5-year period, increasing throughout the first 12 months and declining thereafter. After controlling for other predictors, shorter posttraumatic amnesia duration (odds ratio = 0.96, 95 CI = 0.92-1.00), other concurrent psychiatric disorder (odds ratio = 14.22, 95 CI = 2.68-75.38), and lower GOSE (odds ratio = 0.38, 95 CI = 0.20-0.72) and QOLI scores (odds ratio = 0.97, 95 CI = 0.95-0.97) were associated with greater odds of having injury-related PTSD. Discussion: The results of this study indicate that while shorter posttraumatic amnesia duration is associated with PTSD, greater TBI severity does not prevent PTSD from evolving. Patients with PTSD experienced high rates of psychiatric comorbidity and poorer functional and quality of life outcomes after TBI. Conclusion: There is a need to direct clinical attention to early identification and treatment of PTSD following TBI to improve outcomes",
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Factors associated with posttraumatic stress disorder following moderate to severe traumatic brain injury: a prospective study. / Alway, Yvette; McKay, Adam; Gould, Kate Rachel; Johnston, Lisa Susan; Ponsford, Jennie.

In: Depression and Anxiety, Vol. 33, No. 1, 01.01.2016, p. 19-26.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Factors associated with posttraumatic stress disorder following moderate to severe traumatic brain injury: a prospective study

AU - Alway, Yvette

AU - McKay, Adam

AU - Gould, Kate Rachel

AU - Johnston, Lisa Susan

AU - Ponsford, Jennie

PY - 2016/1/1

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N2 - Background: This study prospectively examined the relationship between preinjury, injury-related, and postinjury factors and posttraumatic stress disorder (PTSD) following moderate to severe traumatic brain injury (TBI). Method: Two hundred and three participants were recruited during inpatient admission following moderate to severe TBI. Participants completed an initial assessment soon after injury and were reassessed at 3, 6, and 12 months, 2, 3, 4, and 5 years postinjury. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-fourth edition was used to diagnose pre- and postinjury PTSD and other psychiatric disorders. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Inventory (QOLI) were used to evaluate functional and psychosocial outcome from 6 months postinjury. Results: The frequency of PTSD ranged between 0.5 and 9.4 during the 5-year period, increasing throughout the first 12 months and declining thereafter. After controlling for other predictors, shorter posttraumatic amnesia duration (odds ratio = 0.96, 95 CI = 0.92-1.00), other concurrent psychiatric disorder (odds ratio = 14.22, 95 CI = 2.68-75.38), and lower GOSE (odds ratio = 0.38, 95 CI = 0.20-0.72) and QOLI scores (odds ratio = 0.97, 95 CI = 0.95-0.97) were associated with greater odds of having injury-related PTSD. Discussion: The results of this study indicate that while shorter posttraumatic amnesia duration is associated with PTSD, greater TBI severity does not prevent PTSD from evolving. Patients with PTSD experienced high rates of psychiatric comorbidity and poorer functional and quality of life outcomes after TBI. Conclusion: There is a need to direct clinical attention to early identification and treatment of PTSD following TBI to improve outcomes

AB - Background: This study prospectively examined the relationship between preinjury, injury-related, and postinjury factors and posttraumatic stress disorder (PTSD) following moderate to severe traumatic brain injury (TBI). Method: Two hundred and three participants were recruited during inpatient admission following moderate to severe TBI. Participants completed an initial assessment soon after injury and were reassessed at 3, 6, and 12 months, 2, 3, 4, and 5 years postinjury. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-fourth edition was used to diagnose pre- and postinjury PTSD and other psychiatric disorders. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Inventory (QOLI) were used to evaluate functional and psychosocial outcome from 6 months postinjury. Results: The frequency of PTSD ranged between 0.5 and 9.4 during the 5-year period, increasing throughout the first 12 months and declining thereafter. After controlling for other predictors, shorter posttraumatic amnesia duration (odds ratio = 0.96, 95 CI = 0.92-1.00), other concurrent psychiatric disorder (odds ratio = 14.22, 95 CI = 2.68-75.38), and lower GOSE (odds ratio = 0.38, 95 CI = 0.20-0.72) and QOLI scores (odds ratio = 0.97, 95 CI = 0.95-0.97) were associated with greater odds of having injury-related PTSD. Discussion: The results of this study indicate that while shorter posttraumatic amnesia duration is associated with PTSD, greater TBI severity does not prevent PTSD from evolving. Patients with PTSD experienced high rates of psychiatric comorbidity and poorer functional and quality of life outcomes after TBI. Conclusion: There is a need to direct clinical attention to early identification and treatment of PTSD following TBI to improve outcomes

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KW - anxiety disorder

KW - Posttraumatic stress disorder

KW - quality of life

KW - Rehabilitation

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