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Prognosis after Mild Traumatic Brain Injury: Influence of Psychiatric Disorders

Authors :
Risto Vataja
Raj Rahul
Susanna Melkas
Daniela Trpeska Marinkovic
Harri Isokuortti
Antti Huovinen
Taina Nybo
Ivan Marinkovic
Kaisa Mäki
Antti Korvenoja
HUS Neurocenter
Department of Neurosciences
Neurologian yksikkö
University of Helsinki
Helsinki University Hospital Area
HUS Psychiatry
Department of Psychiatry
Department of Diagnostics and Therapeutics
HUS Medical Imaging Center
Neurokirurgian yksikkö
Staff Services
Source :
Brain Sciences, Brain Sciences; Volume 10; Issue 12; Pages: 916, Brain Sciences, Vol 10, Iss 916, p 916 (2020)
Publication Year :
2020
Publisher :
MDPI, 2020.

Abstract

Background: We evaluated the prevalence of psychiatric disorders in mild traumatic brain injury (MTBI) patients and investigated psychiatric comorbidity in relation to subjective symptoms and return to work (RTW). Methods: We recruited 103 MTBI patients (mean age 40.8 years, SD 3.1) prospectively from University Hospital. The patients were followed up for one year. The Rivermead Post-Concussion Symptom Questionnaire (RPQ) and Extended Glasgow Outcome Scale (GOSE) were administered one month after MTBI. Three months after MTBI, any psychiatric disorders were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders. Results: Psychiatric disorders were diagnosed in 26 patients (25.2%). The most common disorders were previous/current depression. At three months, there was no difference between patients with psychiatric disorders versus those without them in RTW (95.7% vs. 87.3%, p = 0.260) or at least in part-time work (100% vs. 94.4%, p = 0.245). In Kaplan–Meier analysis, the median time to RTW was 10 days for both groups. The median RPQ score was 13.0 (Interquartile range (IQR) 6.5–19.0) in patients with a psychiatric disorder compared to 8.5 (IQR 2.3–14.0) in those without one (p = 0.021); respectively, the median GOSE was 7.0 (IQR 7.0–8.0) compared to 8.0 (IQR 7.0–8.0, p = 0.003). Conclusions: Approximately every fourth patient with MTBI had a psychiatric disorder. These patients reported more symptoms, and their functional outcome measured with GOSE at one month after MTBI was worse. However, presence of any psychiatric disorder did not affect RTW. Early contact and adequate follow-up are important when supporting the patient’s return to work.

Details

Language :
English
ISSN :
20763425
Volume :
10
Issue :
12
Database :
OpenAIRE
Journal :
Brain Sciences
Accession number :
edsair.doi.dedup.....c37d9ced49bd1c5842b4b836c48c6d28