Research Reports - Post-traumatic epilepsy associations with mental health outcomes in the first two years after TBI

pilepsy Behav. 2017 Jun 25;73:240-246. doi: 10.1016/j.yebeh.2017.06.001. [Epub
ahead of print]

Juengst SB(1), Wagner AK(2), Ritter AC(3), Szaflarski JP(4), Walker WC(5),
Zafonte RD(6), Brown AW(7), Hammond FM(8), Pugh MJ(9), Shea T(10), Krellman
JW(11), Bushnik T(12), Arenth PM(1).

PURPOSE: Research suggests that there are reciprocal relationships between mental
health (MH) disorders and epilepsy risk. However, MH relationships to
post-traumatic epilepsy (PTE) have not been explored. Thus, the objective of this
study was to assess associations between PTE and frequency of depression and/or
anxiety in a cohort of individuals with moderate-to-severe TBI who received acute
inpatient rehabilitation.
METHODS: Multivariate regression models were developed using a recent (2010-2012)
cohort (n=867 unique participants) from the TBI Model Systems (TBIMS) National
Database, a time frame during which self-reported seizures, depression [Patient
Health Questionnaire (PHQ)-9], and anxiety [Generalized Anxiety Disorder (GAD-7)]
follow-up measures were concurrently collected at year-1 and year-2 after injury.
RESULTS: PTE did not significantly contribute to depression status in either the
year-1 or year-2 cohort, nor did it contribute significantly to anxiety status in
the year-1 cohort, after controlling for other known depression and anxiety
predictors. However, those with PTE in year-2 had 3.34 times the odds (p=.002) of
having clinically significant anxiety, even after accounting for other relevant
predictors. In this model, participants who self-identified as Black were also
more likely to report clinical symptoms of anxiety than those who identified as
White. PTE was the only significant predictor of comorbid depression and anxiety
at year-2 (Odds Ratio 2.71; p=0.049).
CONCLUSIONS: Our data suggest that PTE is associated with MH outcomes 2years
after TBI, findings whose significance may reflect reciprocal, biological,
psychological, and/or experiential factors contributing to and resulting from
both PTE and MH status post-TBI. Future work should consider temporal and
reciprocal relationships between PTE and MH as well as if/how treatment of each
condition influences biosusceptibility to the other condition. 

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