Psychiatric challenges in the first 6 years after traumatic brain injury: Cross-sequential analyses of axis I disorders

Teresa A. Ashman, Lisa A. Spielman, Mary R. Hibbard, Jonathan M. Silver, Tina Chandna, Wayne A. Gordon

Research output: Contribution to journalArticlepeer-review

162 Scopus citations

Abstract

Ashman TA, Spielman LA, Hibbard MR, Silver JM, Chandna T, Gordon WA. Psychiatric challenges in the first 6 years after traumatic brain injury: cross-sequential analyses of Axis I disorders. Arch Phys Med Rehabil 2004;85(4 Suppl 2):S36-42. Objective To examine the preinjury rates of Axis I disorders and the prospective rates within the first 6 years after traumatic brain injury (TBI). Design Cross-sectional, longitudinal, and cross-sequential. Setting Community-based research and training center. Participants Persons (N=188) who had sustained TBI within 4 years of enrollment into the project were interviewed at either 2 and 3 assessments. Each assessment was approximately 1 year apart. Several Axis I diagnoses were analyzed to detect cross-sectional differences (by age and time postinjury) and average individual changes over the multiple measurement time points. Interventions Not applicable. Main outcome measure Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. Results The odds ratios changed longitudinally within each subject, indicating a decreased probability of having an Axis I diagnosis over time. There were few cross-sectional differences in age; therefore, age at the time of injury had little impact on Axis I diagnoses. Cross-sectional time since injury was not associated with more psychiatric disorders, whereas cross-sectional preinjury history of psychiatric disorders was predictive of postinjury psychiatric disorders. After controlling for cross-sectional effects, the frequencies of Axis I disorders increased in depression, anxiety, and posttraumatic stress disorders in the first assessment postinjury and declined in subsequent assessments. Conclusions Cross-sequential analyses that control for cross-sectional and longitudinal differences produced a more complete description of psychiatric disorders after TBI.

Original languageEnglish
Pages (from-to)36-42
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume85
Issue numberSUPPL. 2
DOIs
StatePublished - Apr 2004

Keywords

  • Brain injuries
  • Psychiatry
  • Rehabilitation
  • Research design

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