Bockhop Fabian, Cunitz Katrin, Zeldovich Marina, Buchheim Anna, Beissbarth Tim, Hagmayer York, von Steinbuechel Nicole
Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, 37073 Göttingen, Germany.
Institute of Psychology, Faculty of Psychology and Sport Science, University of Innsbruck, 6020 Innsbruck, Austria.
J Clin Med. 2023 Jun 6;12(12):3873. doi: 10.3390/jcm12123873.
Psychopathological symptoms are common sequelae after traumatic brain injury (TBI), leading to increased personal and societal burden. Previous studies on factors influencing Post-traumatic Stress Disorder (PTSD), Generalized Anxiety Disorder (GAD), and Major Depressive Disorder (MDD) after TBI have produced inconclusive results, partly due to methodological limitations. The current study investigated the influence of commonly proposed factors on the clinical impairment, occurrence, frequency, and intensity of symptoms of PTSD, GAD, and MDD after TBI. The study sample comprised 2069 individuals (65% males). Associations between psychopathological outcomes and sociodemographic, premorbid, and injury-related factors were analyzed using logistic regression, standard, and zero-inflated negative binomial models. Overall, individuals experienced moderate levels of PTSD, GAD, and MDD. Outcomes correlated with early psychiatric assessments across domains. The clinical impairment, occurrence, frequency, and intensity of all outcomes were associated with the educational level, premorbid psychiatric history, injury cause, and functional recovery. Distinct associations were found for injury severity, LOC, and clinical care pathways with PTSD; age and LOC:sex with GAD; and living situation with MDD, respectively. The use of suitable statistical models supported the identification of factors associated with the multifactorial etiology of psychopathology after TBI. Future research may apply these models to reduce personal and societal burden.
精神病理症状是创伤性脑损伤(TBI)后的常见后遗症,导致个人和社会负担加重。先前关于影响TBI后创伤后应激障碍(PTSD)、广泛性焦虑障碍(GAD)和重度抑郁症(MDD)因素的研究结果尚无定论,部分原因是方法学上的局限性。本研究调查了常见因素对TBI后PTSD、GAD和MDD症状的临床损害、发生、频率和强度的影响。研究样本包括2069名个体(65%为男性)。使用逻辑回归、标准和零膨胀负二项式模型分析了精神病理结果与社会人口统计学、病前和损伤相关因素之间的关联。总体而言,个体经历了中度水平的PTSD、GAD和MDD。结果与各领域的早期精神评估相关。所有结果的临床损害、发生、频率和强度均与教育水平、病前精神病史、损伤原因和功能恢复有关。分别发现损伤严重程度、意识丧失(LOC)和临床护理途径与PTSD存在显著关联;年龄和LOC:性别与GAD存在显著关联;生活状况与MDD存在显著关联。使用合适的统计模型有助于识别与TBI后精神病理学多因素病因相关的因素。未来的研究可以应用这些模型来减轻个人和社会负担。