Klyce DW, Stromberg KA, Walker WC, Sima AP, Hoffman JM, Graham KM, Agyemang AA, Marwitz JH. Arch. Phys. Med. Rehabil. 2019; ePub(ePub): ePub.
Affiliation
Virginia Commonwealth University, Department of Physical Medicine and Rehabilitation; Virginia Commonwealth University, Department of Biostatistics; University of Washington, Department of Rehabilitation Medicine.
OBJECTIVE: To examine the predictive ability of depression when considering long-term employment outcomes for individuals with moderate-to-severe TBI, after controlling for key pre-injury and injury-related variables.
DESIGN: Secondary data analysis. SETTING: Community follow-up after discharge from an inpatient rehabilitation center. PARTICIPANTS: Individuals between 18 and 60 years-old with moderate-to-severe TBI enrolled in the Traumatic Brain Injury Model Systems (TBIMS) database. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Employment status.
RESULTS: The prevalence of employment at 2 and 5 years post-injury was 40.3% and 44.5%, respectively. Individuals identified at depressed at 1 year were less likely to be employed at 2 years post-injury (OR=1.77; 95% CI: 1.38, 2.27; p<.0001). Similar relations between current depression and future employment were observed from 1- and 2-year depression status predicting 5-year employment (1-year: OR=1.88; 95%CI: 1.48, 2.40; p<.0001: 2-year: OR=1.72, 95%CI: 1.36, 2.17; p<.0001).
CONCLUSIONS: After controlling for baseline predictors variables, the experience of post-injury depression-a modifiable condition-contributes predictive ability to future employment outcomes. Incorporating assessments/interventions for depression into post-acute rehabilitation programs could promote favorable employment outcomes after TBI.