Article

OBJECTIVE: To determine at 1 year after moderate to severe traumatic brain injury
the (1) rate of clinically significant anxiety; (2) rates of specific symptoms of
anxiety; (3) risk factors for anxiety; and (4) associations of anxiety with other
1-year outcomes, including participation and quality of life. DESIGN: Prospective
longitudinal observational study. SETTING: Inpatient rehabilitation centers, with
data capture at injury and 1-year follow-up. PARTICIPANTS: Persons with moderate
to severe traumatic brain injury who were enrolled in the Traumatic Brain Injury
Model Systems database (N=1838). INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: The 7-item Generalized Anxiety Disorder Scale, Patient Health
Questionnaire (9-item screen for depression), FIM, Participation Assessment with
Recombined Tools-Objective, and Satisfaction with Life Scale. RESULTS: Clinically
significant anxiety was reported by 21% of the participants. Of these, >80%
reported interference with daily activities, with the most common symptoms being
excessive worry and irritability. A common pattern was comorbid anxiety and
depression, with smaller proportions reporting either disorder alone. Anxiety had
large effect sizes with respect to life satisfaction and cognitive disability and
medium to small effect sizes relative to societal participation and self-care.
Middle age, black race, lower socioeconomic status, preinjury mental health
treatment, and at least 1 traumatic brain injury prior to the index injury were
all risk factors for later anxiety. CONCLUSIONS: Anxiety should be screened,
fully evaluated, and treated after moderate to severe traumatic brain injury.
Worry and irritability might be treated with pharmacologic agents or relatively
simple behavioral interventions, which should be further researched in this
population.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS