Citation

Haarbauer-Krupa J, Taylor CA, Yue JK, Winkler EA, Pirracchio R, Cooper SR, Burke JF, Stein MB, Manley GT. J. Neurotrauma 2016; 34(1): 50-58.

Affiliation

Brain and Spinal Injury Center, San Francisco, California, United States ; manleyg@neurosurg.ucsf.edu.

Copyright

(Copyright © 2016, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2015.4158

PMID

26936513

Abstract

Post-traumatic stress disorder (PTSD) is a condition associated with traumatic brain injury (TBI). While the importance of PTSD and TBI among military personnel is widely recognized, there is less awareness of PTSD associated with civilian TBI. We examined the incidence and factors associated with PTSD six months post-injury in a civilian emergency department population using measures from the (NINDS) TBI Common Data Elements (TBI-CDE) Outcome Battery. Participants with mild TBI (mTBI) from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot study with complete six-month outcome batteries (N=280) were analyzed. Screening for PTSD symptoms was conducted using the PTSD Checklist-Civilian Version (PCL-C). Descriptive measures are summarized and predictors for PTSD were examined using logistic regression. Incidence of screening positive for PTSD was 26.8% at six months following mTBI. Screening positive for PTSD was significantly associated with concurrent functional disability, postconcussive and psychiatric symptomatology, decreased satisfaction with life, and decreased performance in visual processing and mental flexibility. Multivariable regression showed injury mechanism of assault (odds ratio (OR) 3.59, 95% confidence interval (CI) 1.69-7.63, p=0.001) and prior psychiatric history (OR 2.56, 95% CI 1.42-4.61, p=0.002) remained significant predictors of screening positive for PTSD, while education (per-year OR 0.88, 95% CI 0.79-0.98, p=0.021) was associated with decreased odds of PTSD. Standardized data collection and review of pre-injury education, psychiatric history, and injury mechanism during initial hospital presentation can aid in identifying patients with mTBI at risk for developing PTSD symptoms, who may benefit from closer follow-up after initial injury care.

Language: en