Research Reports - Anxiety and comorbid depression following traumatic brain injury

J Affect Disord. 2017 Apr 15;213:214-221. doi: 10.1016/j.jad.2016.09.045. Epub
2016 Oct 5.

Osborn AJ(1), Mathias JL(2), Fairweather-Schmidt AK(3), Anstey KJ(4).

BACKGROUND: Anxiety is common following a traumatic brain injury (TBI), but who
is most at risk, and to what extent, is not well understood.
METHODS: Longitudinal data from a randomly-selected community sample (Wave 1:
7397, Wave 2: 6621 and Wave 3: 6042) comprising three adult cohorts (young: 20-24
years of age, middle-aged: 40-44, older: 60-64), were analysed. The association
between TBI history, anxiety and comorbid depression was assessed, controlling
for age, sex, marital/employment status, medical conditions, recent life events,
alcohol consumption, social support and physical activity.
RESULTS: Thirteen percent of the sample had sustained a TBI by Wave 3, 35% of
whom had sustained multiple TBIs. Cross-sectional analyses revealed that
clinically-significant anxiety was more common in people who had sustained a TBI.
Longitudinal analyses demonstrated an increased risk of anxiety post-TBI, even
after controlling for potential demographic, health and psychosocial confounds.
Anxiety was more common than depression, although 10% of those with a TBI
experienced comorbid anxiety/depression.
LIMITATIONS: TBIs were not medically confirmed and anxiety and depression were
only assessed every four years by self-report, rather than clinical interview.
Sample attrition resulted in the retention of healthier individuals at each wave.
CONCLUSIONS: TBIs are associated with a lifelong increased risk of experiencing
clinically-significant anxiety, highlighting the chronic nature of TBI sequelae.
Positive lifestyle changes (e.g., increasing physical activity, reducing alcohol
consumption) may decrease the risk of anxiety problems in the early years after a
TBI. Comorbid anxiety and depression was common, indicating that both should be
monitored and treated.

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