Rehabilitation Trajectories and Outcomes in Individuals With Mild Traumatic Brain Injury and Psychiatric Histories: A TRACK-TBI Pilot Study

J Head Trauma Rehabil. Jan/Feb 2019;34(1):36-44. doi: 10.1097/HTR.0000000000000399.

Abstract

Objective: To determine differences in rehabilitation trajectories and return to work (RTW) and social outcomes in individuals with mild traumatic brain injury (mTBI) with and without significant psychiatric histories at index hospitalization.

Setting: Three level 1 trauma centers participating in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) consortium.

Participants: A total of 305 individuals with index mTBI enrolled in the TRACK-TBI pilot project.

Design: Secondary analysis of data from the TRACK-TBI pilot study.

Main measures: Chart review and patient/family interview at emergency department (ED) admission, ED clinical data, ED discharge plan, functional interview data at 3- and 6-month outcomes, Trail Making Tests, the Wechsler Adult Intelligence Scale, Fourth Edition, Processing Speed Index, the California Verbal Learning Test, Second Edition, and the Craig Handicap Assessment and Reporting Technique.

Results: Controlling for neurological history and CT lesion at ED admission, participants with and without psychiatric histories did not differ in terms of treatment, return to work, or reported social function. Individuals with psychiatric histories demonstrated lower processing speed and reported reduced satisfaction with occupational function at outcome.

Conclusions: Individuals with mTBI and psychiatric histories may require specialized rehabilitation planning to address increased risk for cognitive difficulties and occupational dissatisfaction at outcome. CT lesion may independently influence outcomes.

MeSH terms

  • Adult
  • Brain Injuries, Traumatic / epidemiology
  • Brain Injuries, Traumatic / rehabilitation*
  • Datasets as Topic
  • Female
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Neuropsychological Tests
  • Pilot Projects
  • Return to Work*
  • Social Integration*