Karoline Doser1,2,3, Ingrid Poulsen3, Alexander Wuensch4, Anne Norup5. 1. a Survivorship Unit , Danish Cancer Society Research Center , Copenhagen , Denmark. 2. b Department of Clinical Pedagogic and Therapeutic Studies , Catholic University of Applied Sciences , Freiburg , Germany. 3. c Department of Neurorehabilitation, Traumatic Brain Injury , Research Unit on Brain Injury Rehabilitation Copenhagen, (RUBRIC) Rigshospitalet, Copenhagen University Hospital , Copenhagen , Denmark. 4. d Department of Psychosomatic Medicine and Psychotherapy, Medical Center , University of Freiburg, Faculty of Medicine , Freiburg , Germany. 5. e Department of Neurology, National Study of Young Brain Injury Survivors , Rigshospitalet, Copenhagen University Hospital , Glostrup , Denmark.
Abstract
OBJECTIVES: Young individuals surviving severe traumatic brain injury (TBI) frequently experience a wide range of cognitive, emotional and behavioural consequences. This cross-sectional follow-up study investigated psychological outcome of young survivors in the chronic phase, and whether psychological outcome was associated with improvement of functional abilities during sub-acute admission. METHODS: Patients, who acquired a severe TBI during adolescence or early adulthood (n = 36) and received early intensive rehabilitation, were contacted for follow-up assessment concerning psychological outcome and completed the Adult Self Report 18-59 (ASR18-59). Demographic data, functional outcomes and severity measures were obtained from the local database. RESULTS: The participants had a mean age of 24.1 years (SD = 4.1) at follow-up, and the mean time since injury was 72.1 months (SD = 44.2). Results showed significantly higher scores compared with the normative reference population in relation to the subscales withdrawal/isolation (p = 0.013), attention problems (p = 0.008) and intrusive behaviour (p = 0.046). Pearson correlation analyses showed that young survivors experiencing more functional improvement during inpatient rehabilitation had fewer psychological problems during the chronic phase in the subscales: withdrawal/isolation, rule breaking, intrusive behaviour and total problems. CONCLUSION: Young patients reported psychological problems in several areas during the chronic phase of injury, which may hinder complete reintegration and participation in society. Larger functional improvement during sub-acute rehabilitation seemed to be associated with less psychological problems in the chronic phase.
OBJECTIVES: Young individuals surviving severe traumatic brain injury (TBI) frequently experience a wide range of cognitive, emotional and behavioural consequences. This cross-sectional follow-up study investigated psychological outcome of young survivors in the chronic phase, and whether psychological outcome was associated with improvement of functional abilities during sub-acute admission. METHODS:Patients, who acquired a severe TBI during adolescence or early adulthood (n = 36) and received early intensive rehabilitation, were contacted for follow-up assessment concerning psychological outcome and completed the Adult Self Report 18-59 (ASR18-59). Demographic data, functional outcomes and severity measures were obtained from the local database. RESULTS: The participants had a mean age of 24.1 years (SD = 4.1) at follow-up, and the mean time since injury was 72.1 months (SD = 44.2). Results showed significantly higher scores compared with the normative reference population in relation to the subscales withdrawal/isolation (p = 0.013), attention problems (p = 0.008) and intrusive behaviour (p = 0.046). Pearson correlation analyses showed that young survivors experiencing more functional improvement during inpatient rehabilitation had fewer psychological problems during the chronic phase in the subscales: withdrawal/isolation, rule breaking, intrusive behaviour and total problems. CONCLUSION: Young patients reported psychological problems in several areas during the chronic phase of injury, which may hinder complete reintegration and participation in society. Larger functional improvement during sub-acute rehabilitation seemed to be associated with less psychological problems in the chronic phase.
Entities:
Keywords:
TBI; adolescents; chronic phase; psychological outcome; young adults
Authors: Paula Kersten; Christine Cummins; Nicola Kayes; Duncan Babbage; Hinemoa Elder; Allison Foster; Mark Weatherall; Richard John Siegert; Greta Smith; Kathryn McPherson Journal: BMJ Open Date: 2018-10-10 Impact factor: 2.692