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Arif H, Troyer EA, Paulsen JS, Vaida F, Wilde EA, Bigler ED, Hesselink JR, Yang TT, Tymofiyeva O, Wade O, Max JE. Long-Term Psychiatric Outcomes in Adults with History of Pediatric Traumatic Brain Injury. J Neurotrauma 2021; 38:1515-1525. [PMID: 33765846 PMCID: PMC8336207 DOI: 10.1089/neu.2020.7238] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The objective of the study was to compare psychiatric outcomes in adults with and without history of pediatric traumatic brain injury (TBI). Youth ages 6 to 14 years hospitalized for TBI from 1992 to 1994 were assessed at baseline and at 3, 6, 12, and 24 months post-injury. In the current study, psychiatric assessments were repeated at 24 years post-injury with the same cohort, now adults ages 29 to 39 years. A control group of healthy adults also was recruited for one-time cross-sectional assessments. Outcome measures included: 1) presence of a psychiatric disorder since the 24-month assessment not present before the TBI ("novel psychiatric disorder," NPD), or in the control group, the presence of a psychiatric disorder that developed after the mean age of injury of the TBI group plus 2 years; and 2) Time-to-Event for onset of an NPD during the same time periods. In the TBI group, NPDs were significantly more common, and presence of a current NPD was significantly predicted by presence of a pre-injury lifetime psychiatric disorder and by abnormal day-of-injury computed tomography (CT) scan. Compared with controls, the TBI group also had significantly shorter Time-to-Event for onset of any NPD. These findings demonstrate that long-term psychiatric outcomes in adults previously hospitalized for pediatric TBI are significantly worse when compared with adult controls without history of pediatric TBI, both in terms of prevalence and earlier onset of NPD. Further, in the TBI group, long-term NPD outcome is predicted independently by presence of pre-injury psychiatric disorder and abnormal day-of-injury CT scan.
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Affiliation(s)
- Hattan Arif
- Departments of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Emily A. Troyer
- Departments of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Jane S. Paulsen
- Departments of Neuroscience, University of Iowa, Iowa City, Iowa, USA
- Neurology, University of Iowa, Iowa City, Iowa, USA
- Psychiatry, and University of Iowa, Iowa City, Iowa, USA
- Psychology, University of Iowa, Iowa City, Iowa, USA
| | - Florin Vaida
- Family Medicine and Public Health, University of California, San Diego, San Diego, California, USA
| | - Elisabeth A. Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Erin D. Bigler
- Department of Psychology and Neuroscience, Brigham Young University, Provo, Utah, USA
| | - John R. Hesselink
- Radiology, University of California, San Diego, San Diego, California, USA
| | - Tony T. Yang
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Olga Tymofiyeva
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Owen Wade
- Psychiatry, and University of Iowa, Iowa City, Iowa, USA
| | - Jeffrey E. Max
- Departments of Psychiatry, University of California, San Diego, San Diego, California, USA
- Psychiatry, and University of Iowa, Iowa City, Iowa, USA
- Rady Children's Hospital, San Diego, San Diego, California, USA
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