Prognostic models for depression and post-traumatic stress disorder symptoms following traumatic brain injury: a CENTER-TBI study

BMJ Mental Health, Journal Year: 2025, Volume and Issue: 28(1), P. e301181 - e301181

Published: Jan. 1, 2025

Background Traumatic brain injury (TBI) is associated with an increased risk of major depressive disorder (MDD) and post-traumatic stress (PTSD). We aimed to identify predictors develop models for the prediction depression PTSD symptoms at 6 months post-TBI. Methods analysed data from Collaborative European NeuroTrauma Effectiveness Research in Brain Injury study. used linear regression model relationship between (Patient Health Questionnaire-9) (PTSD Checklist Diagnostic Statistical Manual Mental Disorders Fifth Edition). Predictors were selected based on Akaike’s Information Criterion. Additionally, we fitted logistic endpoints ‘probable MDD’ PTSD’. also examined incremental prognostic value 2–3 weeks symptoms. Results included 2163 adults (76% Glasgow Coma Scale=13–15). Depending scoring criteria, 7–18% screened positive probable MDD about 10% PTSD. For both outcomes, psychiatric history, employment status, sex, cause, alcohol intoxication total severity; preinjury health education. The performance was modest (proportion explained variance=R 2 8% 7% PTSD, respectively). Symptoms assessed had a large (delta R =0.25, 95% CI 0.24 0.26 symptoms; delta =0.30, 0.29 0.31 PTSD). Conclusion Preinjury characteristics, such as history unemployment, violent can increase mental problems after TBI. identification patients should be guided by early screening health.

Language: Английский

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Concussion rehabilitation through a cervical spine intervention lens: a scoping review

Physical Therapy Reviews, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 17

Published: Jan. 22, 2025

Language: Английский

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Supportive Elements and Challenges to Return to Work Following a Concussion: A Scoping Review

Journal of Head Trauma Rehabilitation, Journal Year: 2025, Volume and Issue: unknown

Published: April 22, 2025

Objective: This scoping review aims to comprehensively explore the facilitators and barriers influencing return work (RTW) process following a concussion, with focus on person impacted by medical system, funder, workplace domains. Design: A of electronic databases, including CINAHL, Embase, MEDLINE, PsycINFO Web Science, was conducted identify relevant studies published up April 6, 2024. Studies were included if they examined factors RTW concussion available in English. Data extraction, numerical analysis deductive content performed determine key themes from data. Reporting guidelines provided PRISMA-ScR adhered to, protocol has been registered can be accessed at Open Science Framework. Results: Twenty met inclusion criteria review. Findings organized into 4 main process: workplace. These further categorized 2 subthemes: supportive elements challenges. Various within each theme identified, such as individualized rehabilitation services, graduated work, developing personal agency individual concussion. Challenges lack patient education, delayed access isolating accommodations highlighted. findings underscore complex interplay shaping trajectory post-concussion. Conclusion: provides detailed examination challenges The identified offer valuable insights for clinicians researchers seeking optimize outcomes support individuals re-entering workforce after Future research should prioritize an policies practices, assessing long-term outcomes, strategies integrate systems enhance experience.

Language: Английский

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Somatic Symptom Disorder After Mild Traumatic Brain Injury

Journal of Head Trauma Rehabilitation, Journal Year: 2025, Volume and Issue: unknown

Published: May 9, 2025

Objective: Mild traumatic brain injury (mTBI) may be a common precipitant of Somatic Symptom Disorder (SSD). This study examined the prevalence, correlates, predictors, and functional impact SSD after mTBI. Setting: Follow up patients recruited from emergency departments urgent care centers. Participants: Adults with mTBI (N = 476). Design: Secondary analysis clinical trial (Clinicaltrials.gov NCT04704037). Main Measures: Early illness beliefs (Illness Perceptions Questionnaire-Revised; IPQ-R) were assessed ~2 weeks outcomes at 6 months post-injury, including symptoms (Somatic Disorder-B Criteria Scale; SSD-12), post-concussion (Rivermead Post Concussion Symptoms Questionnaire; RPQ), disability (World Health Organization Disability Assessment Schedule; WHODAS), psychiatric diagnoses (MINI Neuropsychiatric Inventory). diagnosis was operationalized as having persistent SSD-12 ≥ 16 (≥23 in sensitivity analyses). Results: 15-27% sample met criteria for post-injury. Participants reported more pain symptoms, likely to have comorbid Major Depressive (OR 9.1, 95% CI 5.3, 16.2) least 1 anxiety disorder 5.6, 3.6-8.8) compared those without SSD. beliefs, specifically that has serious life consequences 1.2, 1.1-1.3) causes distress 1.1, 1.0-1.2), associated later contributed prediction global (WHODAS) over above symptom severity (RPQ; ΔDeviance 0.22, P < .001). Conclusions: is an increased burden comorbidity, disability. identification at-risk appears feasible. useful framework conceptualizing poor outcome prominent psychological guiding rehabilitation.

Language: Английский

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Diagnostic Accuracy of Mental Health Screening Tools After Mild Traumatic Brain Injury

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(7), P. e2424076 - e2424076

Published: July 23, 2024

Importance Mental health disorders are common after mild traumatic brain injury (mTBI) and likely exacerbate postconcussive symptoms disability. Early detection could improve clinical outcomes, but the accuracy of mental screening tools in this population has not been well established. Objective To determine diagnostic Patient Health Questionnaire–9 (PHQ-9), Generalizaed Anxiety Disorder–7 (GAD-7), Primary Care PTSD (Posttramatic Stress Disorder) Screen for Diagnostic Statistical Manual Disorders (Fifth Edition) ( DSM-5 ) (PC-PTSD-5) adults with mTBI. Design, Setting, Participants This study was performed as a secondary analysis cluster randomized trial. Self-report (PHQ-9, GAD-7, PC-PTSD-5) were administered online 12 weeks mTBI compared against structured psychodiagnostic interview (Mini-International Neuropsychiatric Interview (MINI) over videoconference at same time. Adults (N = 537) recruited from February 1, 2021, to October 25, 2022. Main Outcomes Measures Presence major depressive episode, anxiety disorders, determined by blinded assessor MINI. statistics derived PHQ-9, PC-PTSD-5. Findings disaggregated participants without persistent postconcussion (PPCS) International Classification Diseases, Tenth Revision criteria. Results Data available 499 537 trial participants, 278 (55.7%) whom female; mean (SD) age 38.8 (13.9) years. Each questionnaire had strong overall sample optimal cut points (area under curve [AUC], ≥0.80; sensitivity, 0.55-0.94; specificity, 0.64-0.94). The AUC (difference 0.01-0.13) specificity (difference, 5-65 percentage points) lower those PPCS present absent, prevalence least 1 disorder 3 5 times higher patients present. GAD-7 slightly better performance than PC-PTSD-5 detecting (AUC, 0.85 [95% CI, 0.80-0.89] vs 0.80 0.72-0.87]). cutoff on PHQ-9 or more experienced half days; total score 7. Conclusions Relevance findings suggest that accurately screen Future research should corroborate test cutoffs population.

Language: Английский

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Cognitive-Behavioral Therapy for Persistent Post-Concussive Symptoms in Youth: Adaptations, Treatment Recommendations, and Implementation in Medical Settings

Cognitive and Behavioral Practice, Journal Year: 2024, Volume and Issue: 31(3), P. 399 - 412

Published: Jan. 4, 2024

Language: Английский

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A Scoping Review on the Use of Non-Invasive Brain Stimulation Techniques for Persistent Post-Concussive Symptoms

Biomedicines, Journal Year: 2024, Volume and Issue: 12(2), P. 450 - 450

Published: Feb. 17, 2024

Background: In the context of managing persistent post-concussive symptoms (PPCS), existing treatments like pharmacotherapy, cognitive behavioral therapy, and physical rehabilitation show only moderate effectiveness. The emergence neuromodulation techniques in PPCS management has led to debates regarding optimal stimulation parameters their overall efficacy. Methods: this scoping review involved a comprehensive search PubMed ScienceDirect databases, focusing on controlled studies examining therapeutic potential non-invasive brain (NIBS) adults with PPCS. Results: Among 940 abstracts screened, five studies, encompassing 103 patients (12 29 per study), met inclusion criteria. These assessed efficacy transcranial direct current (tDCS), or repetitive magnetic (rTMS), applied specific regions (i.e., left dorsolateral pre-frontal cortex (DLPFC) motor (M1)) for addressing psychological symptoms, headaches, general PPCSs. results indicated improvements functions tDCS. contrast, reductions headache intensity depression scores were observed rTMS, while no significant findings noted rTMS. Conclusion: although these pilot suggest promise rTMS tDCS management, further research larger-scale investigations standardized protocols is imperative enhance treatment outcomes patients.

Language: Английский

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Work-related and non-work-related mild traumatic brain injury: Associations with mental health and substance use challenges in a Canadian population-level survey

Work, Journal Year: 2024, Volume and Issue: 79(1), P. 331 - 338

Published: Feb. 23, 2024

BACKGROUND: Mild traumatic brain injury (mTBI) can profoundly impact overall health, employment, and family life. Incidence of mTBI in the workplace represents an important subgroup with poorer outcomes. Mental health (MH) substance use (SU) challenges are a primary correlate TBI, but rarely assessed among individuals work-related (wr)-mTBI, particularly at population-level. OBJECTIVE: This study aimed to assess association between lifetime wr-mTBI non-wr-mTBI experience MH SU challenges. METHODS: The 2019 Centre for Addiction Health (CAMH) Monitor is cross-sectional telephone survey adults aged≥18 years Ontario, Canada, employing stratified (six regions) two-stage (telephone number, respondent) list-assisted random digit dialing probability selection procedure (N = 1792). Adjusting sociodemographic variables, binary logistic regression was conducted (relative no TBI) four outcomes: hazardous alcohol cannabis, psychological distress, fair/poor mental health. RESULTS: demonstrated increased odds (AOR 2.12, 95% CI 1.41, 3.19) cannabis 1.61, 1.05, 2.45), distress 1.68, 1.14, 2.49), 1.70, 1.11, 2.59). Lifetime reporting 3.40, 1.93, 5.97) 2.16, 1.12, 4.19) only. CONCLUSIONS: Non-wr-mTBI associated both SU, whereas outcomes were more strongly than non-wr-mTBI. Physicians, employers, insurers need consider potential MH, provide care accordingly.

Language: Английский

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“Using the right tools and addressing the right issue”: A qualitative exploration to support better care for intimate partner violence, brain injury, and mental health

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(10), P. e0311852 - e0311852

Published: Oct. 11, 2024

Background Intimate partner violence (IPV) is a global public health crisis. Often repetitive and occurring over prolonged periods of time, IPV puts survivors at high risk brain injury (BI). Mental concerns are highly prevalent both among individuals who have experienced those BI, yet the interrelatedness complexity these three challenges when together poorly understood. This qualitative study explored care provision for with BI (IPV-BI) mental from perspectives providers. Methods interpretive description was part broader research project exploring employment, health, COVID-19 implications IPV-BI. Participants (N = 24), including service providers, participated in semi-structured group individual interviews between October 2020 February 2021. Interviews were recorded, transcribed, thematically analyzed. Findings Four themes developed interview findings: 1) identifying as contributing components to survivors’ experiences critical getting appropriate care; 2) supporting involves “toolbox full strategies” flexible approach; 3) connecting collaborating across sectors key; 4) underfunding systemic barriers hinder access care. Finally, we share recommendations participants better support survivors. Conclusions Identifying providing supports. Survivors experiencing benefit collaborative approach social systems should be set up approaches.

Language: Английский

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Modified Acceptance and Commitment Psychotherapy in Complex Treatment of Comorbidity of Post-traumatic Stress Disorder and Mild Traumatic Brain Injury

Health of Man, Journal Year: 2023, Volume and Issue: 4, P. 16 - 23

Published: Dec. 28, 2023

The objective: approbation of the effectiveness modified Acceptance and Commitment Therapy in a complex treatment patients with comorbidity posttraumatic stress disorder (PTSD) mild traumatic brain injury (mTBI). Materials methods. 329 veterans from three clinical groups: individuals PTSD (n=109), TBI (n=112) comorbid + (n=108), underwent course combined therapy lasting 8 weeks: addition to standard therapy, they received psychotherapeutic intervention (psychoeducation elements motivational interviewing acceptance commitment for PTSD) transcranial direct current stimulation (tDCS). evaluation treatment, comprehensive psychodiagnostic examination before after included Quality Life Assessment Scale (O. Chaban). Results. Based on obtained data, we can assume that representatives group, who initially evaluated quality social aspects their lives more negatively, looked positively at emotionally colored spheres life (sex mood). At same time, feeling satisfaction was assessed by those were satisfied conditions higher assessment observed who, even had level your sex life. Summarizing it be asserted as result best results direction increasing self-esteem achieved precisely relation PTSD/TBI. Conclusions. Complex using combination tDCS is promising individual methodology this patient population.

Language: Английский

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