Effect of an in-home, family-inclusive rehabilitation programme on depressive symptoms in veterans with traumatic brain injury and its mediation by activity engagement

2020 ◽  
Vol 27 (11) ◽  
pp. 1-13
Author(s):  
Laraine Winter ◽  
Helene J Moriarty ◽  
Keith M Robinson
Keyword(s):  
Traumatic Brain Injury ◽  
Depressive Symptoms ◽  
Brain Injury ◽  
Short Form ◽  
Secondary Analysis ◽  
Depression Scale ◽  
The United States ◽  
Rehabilitation Programme ◽  
Community Reintegration ◽  
Activity Engagement

Background/Aims Depression, the most common psychiatric sequela of traumatic brain injury in both civilians and veterans, produces serious and wide-ranging problems. Although medication and cognitive behavioural therapy are the most common treatments, some rehabilitation approaches designed to enhance functioning and/or community reintegration may decrease depression by facilitating active engagement in life – the key component of some depression therapies. The present secondary analysis of a community reintegration-focused rehabilitation programme for veterans with traumatic brain injury posed two questions: Did the programme affect depressive symptoms? If so, was this effect mediated by engagement in activities? Methods A secondary analysis was undertaken of an intervention study of 83 former members of the United States Armed Forces (veterans) with traumatic brain injury, who were interviewed in their homes. Depressive symptoms were assessed using the short-form Centre for Epidemiological Studies-Depression Scale, activity engagement using an 8-item subscale derived from the Community Reintegration of Injured Service Members Scale, and physical and emotional functioning using the SF-36V. Sociodemographic, medical and military characteristics were elicited during the first interview, and medical and military characteristics were identified through a medical chart review. Results Depressive symptoms significantly decreased among the veterans in the treatment group. That effect was mediated by activity engagement. Thus, the intervention's impact on depressive symptoms was attributable to the increased activity that it produced. Conclusions Research on rehabilitation that enhances engagement in activities should examine its possible benefits for improving mood.

scholarly journals Development of Depressive Symptoms During Early Community Reintegration After Traumatic Brain Injury

2010 ◽  
Vol 17 (01) ◽  
pp. 112-119 ◽  
Author(s):  
Tamara Ownsworth ◽  
Jennifer Fleming ◽  
Terry Haines ◽  
Petrea Cornwell ◽  
Melissa Kendall ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Depressive Symptoms ◽  
Brain Injury ◽  
Community Reintegration

Functional Status, Chronic Stress, and Cortisol Response After Mild-to-Moderate Traumatic Brain Injury

2008 ◽  
Vol 10 (3) ◽  
pp. 213-225 ◽  
Author(s):  
Esther Bay ◽  
Alla Sikorskii ◽  
Fuli Gao
Keyword(s):  
Traumatic Brain Injury ◽  
Depressive Symptoms ◽  
Brain Injury ◽  
Functional Status ◽  
Chronic Stress ◽  
Psychological Functioning ◽  
Rating Scale ◽  
Depression Scale ◽  
Moderate Traumatic Brain Injury ◽  
The Relationship

It is well known that individuals experience difficulties with depressive symptoms and functional status after traumatic brain injury. However, it is unclear what the relationship is between these 2 phenomena and whether there is a biological explanation for. In this secondary analysis, we examined whether depressive symptoms explained postinjury functional status and whether chronic stress and salivary cortisol influenced this relationship. Participants included 75 persons within 24 months of their injury dates who were evaluated or treated in specialty clinics. All participants and a family member or significant other completed survey data, and 50 of the participants provided cortisol data. Results indicated that chronic stress, measured using Cohen's Perceived Stress Scale, completely mediated the relationship between depressive symptoms, measured using the Center for Epidemiological Studies Depression Scale, and psychological functioning, measured using the Patient Competency Rating Scale. Furthermore, those who provided cortisol data displayed hypocortisolemia in their 12-hr profile. Results from this analysis suggest that interventions focused on addressing the chronic stress experience may be important in limiting depressive symptoms and improving psychological functioning. Longitudinal study of this phenomenon is required to understand the progression of chronic stress after traumatic brain injury.

Traumatic Brain Injury: A Trauma Surgeon's Perspective

2012 ◽  
Vol 22 (3) ◽  
pp. 82-89
Author(s):  
Oscar D. Guillamondegui
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Multidisciplinary Approach ◽  
Trauma Team ◽  
The United States ◽  
Long Term Outcomes ◽  
Term Care ◽  
Injured Brain ◽  
The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

Divergence in the epidemiological estimates of traumatic brain injury in the United States: comparison of two national databases

2020 ◽  
pp. 1-10
Author(s):  
Brittany M. Stopa ◽  
Maya Harary ◽  
Ray Jhun ◽  
Arun Job ◽  
Saef Izzy ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Data Bank ◽  
The United States ◽  
National Sample ◽  
Population Based ◽  
Weighted Estimates ◽  
True Incidence ◽  
Ed Visits

OBJECTIVETraumatic brain injury (TBI) is a leading cause of morbidity and mortality in the US, but the true incidence of TBI is unknown.METHODSThe National Trauma Data Bank National Sample Program (NTDB NSP) was queried for 2007 and 2013, and population-based weighted estimates of TBI-related emergency department (ED) visits, hospitalizations, and deaths were calculated. These data were compared to the 2017 Centers for Disease Control and Prevention (CDC) report on TBI, which used the Healthcare Cost and Utilization Project’s National (“Nationwide” before 2012) Inpatient Sample and National Emergency Department Sample.RESULTSIn the NTDB NSP the incidence of TBI-related ED visits was 59/100,000 in 2007 and 62/100,000 in 2013. However, in the CDC report there were 534/100,000 in 2007 and 787/100,000 in 2013. The CDC estimate for ED visits was 805% higher in 2007 and 1169% higher in 2013. In the NTDB NSP, the incidence of TBI-related deaths was 5/100,000 in 2007 and 4/100,000 in 2013. In the CDC report, the incidence was 18/100,000 in both years. The CDC estimate for deaths was 260% higher in 2007 and 325% higher in 2013.CONCLUSIONSThe databases disagreed widely in their weighted estimates of TBI incidence: CDC estimates were consistently higher than NTDB NSP estimates, by an average of 448%. Although such a discrepancy may be intuitive, this is the first study to quantify the magnitude of disagreement between these databases. Given that research, funding, and policy decisions are made based on these estimates, there is a need for a more accurate estimate of the true national incidence of TBI.

scholarly journals Traumatic Brain Injury: Effect of Litigation Status on Executive Functioning—A Pilot Study

2020 ◽  
Author(s):  
Simi Prakash K. ◽  
Rajakumari P. Reddy ◽  
Anna R. Mathulla ◽  
Jamuna Rajeswaran ◽  
Dhaval P. Shukla
Keyword(s):  
Traumatic Brain Injury ◽  
Working Memory ◽  
Depressive Symptoms ◽  
Brain Injury ◽  
Concept Formation ◽  
Verbal Working Memory ◽  
Self Report ◽  
Semantic Fluency ◽  
Set Shifting ◽  
Wide Range

AbstractTraumatic brain injury (TBI) is associated with a wide range of physiological, behavioral, emotional, and cognitive sequelae. Litigation status is one of the many factors that has an impact on recovery. The aim of this study was to compare executive functions, postconcussion, and depressive symptoms in TBI patients with and without litigation. A sample of 30 patients with TBI, 15 patients with litigation (medicolegal case [MLC]), and 15 without litigation (non-MLC) was assessed. The tools used were sociodemographic and clinical proforma, executive function tests, Rivermead Post-Concussion Symptom Questionnaire, and Beck Depression Inventory. Assessment revealed that more than 50% of patients showed deficits in category fluency, set shifting, and concept formation. The MLC group showed significant impairment on verbal working memory in comparison to the non-MLC group. The performance of both groups was comparable on tests of semantic fluency, visuospatial working memory, concept formation, set shifting, planning, and response inhibition. The MLC group showed more verbal working memory deficits in the absence of significant postconcussion and depressive symptoms on self-report measures.

The Benefits of TeleCognitive Training on Depressive Symptoms in Adults with Traumatic Brain Injury

2015 ◽  
Vol 96 (10) ◽  
pp. e105
Author(s):  
Benjamin Douglas Eschler ◽  
Asha K. Vas ◽  
Molly Keebler ◽  
Sandi Chapman ◽  
Kay Moolenijzer
Keyword(s):  
Traumatic Brain Injury ◽  
Depressive Symptoms ◽  
Brain Injury

scholarly journals Adult sports-related traumatic brain injury in United States trauma centers

2016 ◽  
Vol 40 (4) ◽  
pp. E4 ◽  
Author(s):  
Ethan A. Winkler ◽  
John K. Yue ◽  
John F. Burke ◽  
Andrew K. Chan ◽  
Sanjay S. Dhall ◽  
...  
Keyword(s):  
United States ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
The United States ◽  
Mortality Rates ◽  
Hospital Length Of Stay ◽  
Health Concern ◽  
Medical Complications ◽  
Equestrian Sports ◽  
Prolonged Hospital

OBJECTIVE Sports-related traumatic brain injury (TBI) is an important public health concern estimated to affect 300,000 to 3.8 million people annually in the United States. Although injuries to professional athletes dominate the media, this group represents only a small proportion of the overall population. Here, the authors characterize the demographics of sports-related TBI in adults from a community-based trauma population and identify predictors of prolonged hospitalization and increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from adults (age ≥ 18 years) across 5 sporting categories—fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged hospital length of stay (LOS), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α < 0.05, and the Bonferroni correction for multiple comparisons was applied for each outcome analysis. RESULTS From 2003 to 2012, in total, 4788 adult sports-related TBIs were documented in the NTDB, which represented 18,310 incidents nationally. Equestrian sports were the greatest contributors to sports-related TBI (45.2%). Mild TBI represented nearly 86% of injuries overall. Mean (± SEM) LOSs in the hospital or intensive care unit (ICU) were 4.25 ± 0.09 days and 1.60 ± 0.06 days, respectively. The mortality rate was 3.0% across all patients, but was statistically higher in TBI from roller sports (4.1%) and aquatic sports (7.7%). Age, hypotension on admission to the emergency department (ED), and the severity of head and extracranial injuries were statistically significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Traumatic brain injury during aquatic sports was similarly associated with prolonged ICU and hospital LOSs, medical complications, and failure to be discharged to home. CONCLUSIONS Age, hypotension on ED admission, severity of head and extracranial injuries, and sports mechanism of injury are important prognostic variables in adult sports-related TBI. Increasing TBI awareness and helmet use—particularly in equestrian and roller sports—are critical elements for decreasing sports-related TBI events in adults.

Confirmatory factor structure of the Center for Epidemiologic Studies-Depression scale (CES-D) in mild-to-moderate traumatic brain injury

Brain Injury ◽  
2006 ◽  
Vol 20 (5) ◽  
pp. 519-527 ◽  
Author(s):  
Stephen R. McCauley ◽  
Claudia Pedroza ◽  
Sharon A. Brown ◽  
Corwin Boake ◽  
Harvey S. Levin ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Factor Structure ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Moderate Traumatic Brain Injury ◽  
Confirmatory Factor

Traumatic Brain Injury and Psychiatric Co-Morbidity in the United States

2018 ◽  
Vol 90 (1) ◽  
pp. 151-158 ◽  
Author(s):  
Michael G. Vaughn ◽  
Christopher P. Salas-Wright ◽  
Rachel John ◽  
Katherine J. Holzer ◽  
Zhengmin Qian ◽  
...  
Keyword(s):  
United States ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
The United States ◽  
Co Morbidity
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