Journal:Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):16, 97, 5, 701-707
Study examined the rate of clinically significant anxiety at 1 year after moderate-to-severe traumatic brain injury (TBI), specific symptoms of anxiety, risk factors for anxiety; and associations of anxiety with other 1-year outcomes, including participation and quality of life. Participants were 1,838 individuals with moderate-to-severe TBI who were enrolled in the TBI Model Systems database. One-year outcome data were collected using the following measures: 7-item Generalized Anxiety Disorder Scale (anxiety), Patient Health Questionnaire (9-item screen for depression), Functional Independence Measure (cognitive and motor functional status), Participation Assessment with Recombined Tools-Objective (societal participation), and Satisfaction with Life Scale (life satisfaction). Results indicated that clinically significant anxiety was reported by 21 percent of the participants. Of these, more than 80 percent reported interference with daily activities, with the most common symptoms being excessive worry and irritability. A common pattern was comorbid anxiety and depression, with smaller proportions reporting either disorder alone. Anxiety had large effect sizes with respect to life satisfaction and cognitive disability and medium to small effect sizes relative to societal participation and self-care. Middle age, black race, lower socioeconomic status, preinjury mental health treatment, and at least one TBI prior to the index injury were all risk factors for later anxiety. These findings suggest that anxiety should be screened, fully evaluated, and treated after moderate-to-severe TBI. Worry and irritability are common symptoms that might be treated with pharmacologic agents or relatively simple behavioral interventions.