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Citation
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Rabinowitz AR, Chervoneva I, Hart T, O'Neil-Pirozzi TM, Juengst SB, Hoffman JM. Arch. Phys. Med. Rehabil. 2020; ePub(ePub): ePub. |
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Abstract
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OBJECTIVES: To examine heterogeneity in the temporal patterns of depression and participation over the first two years post-TBI.
DESIGN: Observational prospective longitudinal study.
SETTING: Inpatient rehabilitation centers, with 1- and 2-year follow-up conducted primarily by telephone.
PARTICIPANTS: Persons with TBI (N=2307) enrolled in the Traumatic Brain Injury Model Systems database, followed at 1 and 2 years postinjury.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURE: Patient Health Questionnaire-9 (PHQ9) and Participation Assessment with Recombined Tools-Objective (PART-O) RESULTS: Using latent class modeling we examined heterogeneity in the longitudinal relationship between PHQ9 and PART-O. The identified 6 classes were most distinct in terms of 1) level of PHQ9 score and 2) association between the year 1 PART-O score and year 2 PHQ9 score. For most participants, PART-O at year 1 predicted PHQ9 at year 2 more than the reverse. However, there was a subgroup of participants that demonstrated the reverse pattern, PHQ9 predicting later PAR-O, who were on average, older and in the "other" employment category.
CONCLUSIONS: Results suggest that links between participation and depression are stronger for some people living with TBI than for others, and that variation in the temporal sequencing of these two constructs is associated with demographic characteristics. These findings illustrate the value in accounting for population heterogeneity when evaluating temporal among outcome domains.
Language: en |