Longitudinal Analyses of the Reciprocity of Depression and Anxiety after Traumatic Brain Injury and Its Clinical Implications.
Authors
Wang, Biyao
Wu, Yi-Jhen
Covic, Amra
Haagsma, Juanita A
Polinder, Suzanne
Menon, David
von Steinbuechel, Nicole
Center-Tbi Participants And Investigators
Publication Date
2021-11-28Journal Title
J Clin Med
ISSN
2077-0383
Publisher
MDPI AG
Volume
10
Issue
23
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Wang, B., Zeldovich, M., Rauen, K., Wu, Y., Covic, A., Muller, I., Haagsma, J. A., et al. (2021). Longitudinal Analyses of the Reciprocity of Depression and Anxiety after Traumatic Brain Injury and Its Clinical Implications.. J Clin Med, 10 (23) https://doi.org/10.3390/jcm10235597
Abstract
Depression and anxiety are common following traumatic brain injury (TBI). Understanding their prevalence and interplay within the first year after TBI with differing severities may improve patients' outcomes after TBI. Individuals with a clinical diagnosis of TBI recruited for the large European collaborative longitudinal study CENTER-TBI were screened for patient-reported major depression (MD) and generalized anxiety disorder (GAD) at three, six, and twelve months post-injury (N = 1683). Data were analyzed using autoregressive cross-lagged models. Sociodemographic, premorbid and injury-related factors were examined as risk factors. 14.1-15.5% of TBI patients reported moderate to severe MD at three to twelve months after TBI, 7.9-9.5% reported GAD. Depression and anxiety after TBI presented high within-domain persistency and cross-domain concurrent associations. MD at three months post-TBI had a significant impact on GAD at six months post-TBI, while both acted bidirectionally at six to twelve months post-TBI. Being more severely disabled, having experienced major extracranial injuries, an intensive care unit stay, and being female were risk factors for more severe MD and GAD. Major trauma and the level of consciousness after TBI were additionally associated with more severe MD, whereas being younger was related to more severe GAD. Individuals after TBI should be screened and treated for MD and GAD early on, as both psychiatric disturbances are highly persistent and bi-directional in their impact. More severely disabled patients are particularly vulnerable, and thus warrant timely screening and intensive follow-up treatment.
Keywords
major depression, generalized anxiety disorder, traumatic brain injury, longitudinal, reciprocal relationship
Sponsorship
European Union (EC grant 602150)
Identifiers
External DOI: https://doi.org/10.3390/jcm10235597
This record's URL: https://www.repository.cam.ac.uk/handle/1810/331479
Rights
Licence:
https://creativecommons.org/licenses/by/4.0/
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