Citation

Albrecht JS, Peters ME, Smith GCS, Rao V. J. Head Trauma Rehabil. 2017; 32(3): 178-184.

Affiliation

Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore (Drs Albrecht and Smith); Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Drs Peters and Rao); and Shock, Trauma and Anesthesiology Research-Organized Research Center, National Study Center for Trauma and Emergency Medical Services, University of Maryland, College Park (Dr Smith).

Copyright

(Copyright © 2017, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000266

PMID

28476057

Abstract

OBJECTIVE: To estimate rates of anxiety and posttraumatic stress disorder (PTSD) diagnoses after traumatic brain injury (TBI) among Medicare beneficiaries, quantify the increase in rates relative to the pre-TBI period, and identify risk factors for diagnosis of anxiety and PTSD. PARTICIPANTS: A total of 96 881 Medicare beneficiaries hospitalized with TBI between June 1, 2006 and May 31, 2010.

DESIGN: Retrospective cohort study. MEASURES: Diagnosis of anxiety (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 300.0x) and/or PTSD (ICD-9-CM code 309.81).

RESULTS: After TBI, 16 519 (17%) beneficiaries were diagnosed with anxiety and 269 (0.3%) were diagnosed with PTSD. Rates of anxiety and PTSD diagnoses were highest in the first 5 months post-TBI and decreased over time. Pre-TBI diagnosis of anxiety disorder was significantly associated with post-TBI anxiety (risk ratio, 3.55; 95% confidence interval, 3.42-3.68) and pre-TBI diagnosis of PTSD was significantly associated with post-TBI PTSD (risk ratio 70.09; 95% confidence interval 56.29-111.12).

CONCLUSION: This study highlights the increased risk of anxiety and PTSD after TBI. Routine screening for anxiety and PTSD, especially during the first 5 months after TBI, may help clinicians identify these important and treatable conditions, especially among patients with a history of psychiatric illness.

Language: en