BACKGROUND: Psychiatric illness after traumatic brain injury (TBI) has been shown to be prevalent in hospitalized and tertiary care patient populations. OBJECTIVE: To determine the risk of psychiatric illness after TBI in an adult health maintenance organization population. DESIGN: Prospective cohort study. SETTING: Large staff-model health maintenance organization. PARTICIPANTS: Nine hundred thirty-nine health plan members diagnosed as having TBI in 1993 and enrolled in the prior year, during which no TBI was ascertained. Three health plan members per TBI-exposed subject were randomly selected as unexposed comparisons, matched for age, sex, and reference date. MAIN OUTCOME MEASURE: Psychiatric illness in the 3 years after the TBI reference date, determined using computerized records of psychiatric diagnoses according to the International Classification of Diseases, Ninth Revision, Clinical Modification, prescriptions, and service utilization. RESULTS: Prevalence of any psychiatric illness in the first year was 49% following moderate to severe TBI, 34% following mild TBI, and 18% in the comparison group. Among subjects without psychiatric illness in the prior year, the adjusted relative risk for any psychiatric illness in the 6 months following moderate to severe TBI was 4.0 (95% confidence interval [CI], 2.4-6.8) and following mild TBI was 2.8 (95% CI, 2.1-3.7; P<.001) compared with those without TBI. Among subjects with prior psychiatric illness, the adjusted relative risk for any psychiatric illness in the 6 months following moderate to severe TBI was 2.1 (95% CI, 1.3-3.3) and following mild TBI was 1.6 (95% CI, 1.2-2.0; P =.005). Prior psychiatric illness significantly modified the relationship between TBI and subsequent psychiatric illness (P =.04) and was a significant predictor (P<.001). Persons with mild TBI and prior psychiatric illness had evidence of persisting psychiatric illness. CONCLUSIONS: Both moderate to severe and mild TBI are associated with an increased risk of subsequent psychiatric illness. Whereas moderate to severe TBI is associated with a higher initial risk, mild TBI may be associated with persistent psychiatric illness.
BACKGROUND:Psychiatric illness after traumatic brain injury (TBI) has been shown to be prevalent in hospitalized and tertiary care patient populations. OBJECTIVE: To determine the risk of psychiatric illness after TBI in an adult health maintenance organization population. DESIGN: Prospective cohort study. SETTING: Large staff-model health maintenance organization. PARTICIPANTS: Nine hundred thirty-nine health plan members diagnosed as having TBI in 1993 and enrolled in the prior year, during which no TBI was ascertained. Three health plan members per TBI-exposed subject were randomly selected as unexposed comparisons, matched for age, sex, and reference date. MAIN OUTCOME MEASURE: Psychiatric illness in the 3 years after the TBI reference date, determined using computerized records of psychiatric diagnoses according to the International Classification of Diseases, Ninth Revision, Clinical Modification, prescriptions, and service utilization. RESULTS: Prevalence of any psychiatric illness in the first year was 49% following moderate to severe TBI, 34% following mild TBI, and 18% in the comparison group. Among subjects without psychiatric illness in the prior year, the adjusted relative risk for any psychiatric illness in the 6 months following moderate to severe TBI was 4.0 (95% confidence interval [CI], 2.4-6.8) and following mild TBI was 2.8 (95% CI, 2.1-3.7; P<.001) compared with those without TBI. Among subjects with prior psychiatric illness, the adjusted relative risk for any psychiatric illness in the 6 months following moderate to severe TBI was 2.1 (95% CI, 1.3-3.3) and following mild TBI was 1.6 (95% CI, 1.2-2.0; P =.005). Prior psychiatric illness significantly modified the relationship between TBI and subsequent psychiatric illness (P =.04) and was a significant predictor (P<.001). Persons with mild TBI and prior psychiatric illness had evidence of persisting psychiatric illness. CONCLUSIONS: Both moderate to severe and mild TBI are associated with an increased risk of subsequent psychiatric illness. Whereas moderate to severe TBI is associated with a higher initial risk, mild TBI may be associated with persistent psychiatric illness.
Authors: David C Perry; Virginia E Sturm; Matthew J Peterson; Carl F Pieper; Thomas Bullock; Bradley F Boeve; Bruce L Miller; Kevin M Guskiewicz; Mitchel S Berger; Joel H Kramer; Kathleen A Welsh-Bohmer Journal: J Neurosurg Date: 2015-08-28 Impact factor: 5.115
Authors: Jane L Mathias; Yasmin Harman-Smith; Stephen C Bowden; Jeffrey V Rosenfeld; Erin D Bigler Journal: J Neurotrauma Date: 2014-04-01 Impact factor: 5.269
Authors: T W McGlennon; J N Buchwald; Walter J Pories; Fang Yu; Arthur Roberts; Eric P Ahnfeldt; Rukmini Menon; Henry Buchwald Journal: Obes Surg Date: 2020-10-30 Impact factor: 4.129
Authors: Natalie N Nawarawong; Megan Slaker; Matt Muelbl; Alok S Shah; Rachel Chiariello; Lindsay D Nelson; Matthew D Budde; Brian D Stemper; Christopher M Olsen Journal: Eur J Neurosci Date: 2018-12-14 Impact factor: 3.386