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Relationship Between Psychiatric Disorders and 1-Year Psychosocial Outcome Following Traumatic Brain Injury

Gould, Kate Rachel DPsych; Ponsford, Jennie Louise PhD; Johnston, Lisa PhD; Schönberger, Michael PhD

The Journal of Head Trauma Rehabilitation: January/February 2011 - Volume 26 - Issue 1 - p 79–89
doi: 10.1097/HTR.0b013e3182036799
Focus on Clinical Research and Practice: Original Article

Objective: To investigate the relationship of psychiatric functioning with psychosocial functioning at 1 year followingtraumatic brain injury (TBI), after controlling for relevant demographic, injury-related, and concurrent factors.

Design: Prospective 1-year longitudinal study.

Participants: Participants were 122 individuals with TBI and 88 proxy informants.

Setting: Rehabilitation hospital.

Main Measures: The Structured Clinical Interview for DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision)) Axis I Disorders, HospitalAnxiety and Depression Scale, Sydney Psychosocial Reintegration Scale, and Glasgow Outcome Scale-–Extended.

Results: At 1 year postinjury, occupational activities were the area of most change after TBI followed by interpersonal relationships andindependent living skills, according to the Sydney Psychosocial Reintegration Scale. The majority of participants were rated as havingmoderate disability on the Glasgow Outcome Scale-–Extended. After controlling for relevant background factors, preinjury, acutepostinjury, and concurrent psychiatric disorders were significantly related to 1-year psychosocial outcome. Conclusion:Screening in the acute postinjury stage for presence of preinjury psychiatric history or current distress may help identify individualswho require more intensive rehabilitation and psychiatric support and more active postdischarge monitoring. Further research exploringpotential causal mechanisms for these findings is required.

School of Psychology and Psychiatry, Monash University (Drs Gould, Ponsford, and Schönberger), Monash-Epworth Rehabilitation Research Centre Epworth Hospital (Ms Gould and Drs Ponsford, Johnston, and Schönberger), and National Trauma Research Institute (Dr Ponsford), Melbourne, Victoria, Australia.

Corresponding Author: Jennie Louise Ponsford, PhD, School of Psychology and Psychiatry, Monash University, Clayton Campus, VIC 3800, Australia (

The authors thank the Victorian Neurotrauma Initiative for their support.

© 2011 Lippincott Williams & Wilkins, Inc.