Department of Physical Medicine and Rehabilitation, Johns Hopkins Medicine, Baltimore, Maryland (Dr Keatley); Department of Physical Medicine and Rehabilitation, University of Washington, Seattle (Dr Bombardier); Departments of Rehabilitation and Human Performance (Drs Watson, Kumar, and Dams-O'Connor) and Neurology (Dr Dams-O'Connor), Icahn School of Medicine at Mount Sinai, New York, New York; Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham (Dr Novack); and Research Department, Craig Hospital, Englewood, Colorado, and Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis (Dr Monden).
J Head Trauma Rehabil. 2023;38(3):E195-E202. doi: 10.1097/HTR.0000000000000819. Epub 2022 Oct 14.
To evaluate associations between depression, anxiety, and cognitive impairment among individuals with complicated mild to severe traumatic brain injury (TBI) 1 year after injury.
Multiple inpatient rehabilitation units across the United States.
A total of 498 adults 16 years and older who completed inpatient rehabilitation for complicated mild to severe TBI.
Secondary analysis of a prospective, multicenter, cross-sectional observational cohort study.
Assessments of depression (Traumatic Brain Injury Quality of Life [TBI-QOL] Depression) and anxiety (TBI-QOL Anxiety) as well as a telephone-based brief screening measure of cognitive functioning (Brief Test of Adult Cognition by Telephone [BTACT]).
We found an inverse relationship between self-reported depression symptoms and the BTACT Composite score (β = -0.18, P < .01) and anxiety symptoms and the BTACT Composite score (β = -0.20, P < .01). There was no evidence this relationship varied by injury severity. Exploratory analyses showed depression and anxiety were negatively correlated with both BTACT Executive Function factor score and BTACT Memory factor score.
Both depression and anxiety have a small but significant negative association with cognitive performance in the context of complicated mild to severe TBI. These findings highlight the importance of considering depression and anxiety when interpreting TBI-related neuropsychological impairments, even among more severe TBI.
评估创伤性脑损伤（TBI）后 1 年，个体抑郁、焦虑与认知障碍之间的相关性，这些个体患有复杂轻度至重度 TBI。
美国多个住院康复病房。
共 498 名年龄在 16 岁及以上，完成复杂轻度至重度 TBI 住院康复治疗的成年人。
前瞻性、多中心、横断面观察性队列研究的二次分析。
使用创伤性脑损伤生活质量问卷（TBI-QOL）抑郁和焦虑分量表评估抑郁和焦虑，以及使用基于电话的认知功能简短筛查测试（BTACT）进行电话评估。
我们发现，自我报告的抑郁症状与 BTACT 综合评分呈负相关（β=-0.18，P<.01），焦虑症状与 BTACT 综合评分呈负相关（β=-0.20，P<.01）。没有证据表明这种关系因损伤严重程度而有所不同。探索性分析显示，抑郁和焦虑与 BTACT 执行功能因子评分和 BTACT 记忆因子评分均呈负相关。
在复杂轻度至重度 TBI 中，抑郁和焦虑与认知表现均呈轻度但具有统计学意义的负相关。这些发现强调了在解释与 TBI 相关的神经心理损伤时，即使是在更严重的 TBI 中，也要考虑抑郁和焦虑的重要性。
