Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany.
J Int Neuropsychol Soc. 2011 Sep;17(5):781-7. doi: 10.1017/S1355617711000701. Epub 2011 Jun 1.
Poor functional status and high rates of anxiety and depression have been reported in individuals who have sustained a traumatic brain injury (TBI). However, it is unclear whether psychiatric disorders after TBI are a cause or a consequence of functional limitations. The current study aimed to investigate the temporal relationship between anxiety, depression and functional impairment following TBI. The study has a prospective, longitudinal single-group design. Anxiety and depression, assessed using the Structured Clinical Interview for DSM-IV, and functional changes, assessed with the Glasgow Outcome Scale-Extended, were measured six and 12 months post-injury in 122 individuals who had sustained a TBI (79% male, mean age 35 years, mean duration of post-traumatic amnesia 24 days, mean Glasgow Coma Scale score 9.2). Cross-lagged analyses were conducted within a structural equation modelling framework. Functional changes six months post-injury predicted depression and anxiety one year after the injury. Anxiety and depression, in turn, were not predictive of later functional status. This study adds to our understanding of the temporal relationship between depression, anxiety and functional status after TBI. The results indicate the importance of supporting brain injured individuals in coping with the functional consequences of their injury in order promote psychological well-being.
在遭受创伤性脑损伤（TBI）的个体中，报告了较差的功能状态以及较高的焦虑和抑郁发生率。然而，尚不清楚 TBI 后的精神障碍是功能限制的原因还是后果。本研究旨在探讨 TBI 后焦虑、抑郁和功能障碍之间的时间关系。该研究采用前瞻性、纵向单组设计。在 122 名患有 TBI 的个体（79%为男性，平均年龄 35 岁，创伤后遗忘平均持续时间为 24 天，格拉斯哥昏迷量表评分为 9.2）中，使用 DSM-IV 结构临床访谈评估焦虑和抑郁，并使用格拉斯哥结局量表扩展版评估功能变化，分别在损伤后 6 个月和 12 个月进行测量。在结构方程模型框架内进行交叉滞后分析。损伤后 6 个月的功能变化预测了 1 年后的抑郁和焦虑。反过来，焦虑和抑郁对以后的功能状态没有预测作用。本研究增加了我们对 TBI 后抑郁、焦虑和功能状态之间时间关系的理解。结果表明，支持脑损伤个体应对其损伤的功能后果对于促进心理健康非常重要。
