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Abstract
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INTRODUCTION: Previous studies have identified an association between traumatic brain injuries and the development of psychiatric disorders in general. However, these studies were subject to limitations that demonstrate the need for a study of a large, clearly defined mild traumatic brain injury (mTBI) population within an integrated healthcare system.
OBJECTIVE: To determine the prevalence and relative risk of post-injury affective disorders over 4 years following mTBI.
DESIGN: Cohort study of mTBI cases and matched controls, over a 4-year period. SETTING: An integrated healthcare delivery system in California. PATIENTS: 9428 adult health plan members diagnosed with mTBI from 2000-2007 and enrolled in the year prior to injury, during which no TBI was ascertained. Control subjects included 18 856 individuals selected based on the following criteria: Two unexposed health plan members per each mTBI-exposed patient were randomly selected and individually matched for age, sex, race/ethnicity and medical comorbidities. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: A diagnosis of affective disorder (depressive, anxiety, and adjustment disorders) in the 4 years after mTBI or the reference date, determined according to the International Classification of Diseases, Ninth Revision, Clinical Modification, ninth Edition ICD-9-CM as well as the Diagnostic and Statistical Manual fourth TR Edition.
RESULTS: Affective disorders were most prominent during the first 12 months with 23% following mTBI and 14% in the control group. Four-year aggregate adjusted odds ratios for having an affective disorder following mTBI were 1.2 (95% CI: 1.1, 1.2; P < .001) and 1.5 (95% CI: 1.5, 1.6; P < .001) for patients with and without prior affective disorders, respectively.
CONCLUSION: mTBI was associated with a significantly increased risk of having subsequent affective disorders. Screening for and addressing affective disorders at the earlier stages following the injury is an important step to avoid persisting conditions that may pose a barrier to full recovery. This article is protected by copyright. All rights reserved.
Language: en |