Open AccessRelationship of medical comorbidities to psychological health at 2 and 5 years following traumatic brain injury (TBI).
Author(s) -
Emily T. Noyes,
Xinyu Tang,
Angelle M. Sander,
Marc A. Silva,
William C. Walker,
Jacob A. Finn,
Douglas B. Cooper,
Risa NakaseRichardson
Publication year - 2021
Publication title -
rehabilitation psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.673
H-Index - 66
eISSN - 1939-1544
pISSN - 0090-5550
DOI - 10.1037/rep0000366
Subject(s) - comorbidity , medicine , traumatic brain injury , life satisfaction , depression (economics) , patient health questionnaire , clinical psychology , physical therapy , psychiatry , depressive symptoms , psychology , cognition , economics , psychotherapist , macroeconomics
Objective: To examine the relationship between medical comorbidities and psychological health outcomes at 2 and 5 years following traumatic brain injury (TBI). Method: Veterans Affairs (VA) TBI Model System participants who completed a 2-year ( n = 225) and/or 5-year ( n = 283) follow-up with a comorbidities interview were included in the current study. Psychological health outcomes were assessed using the Patient Global Impression of Change (PGIC), Patient Health Questionnaire-9 (PHQ-9), and Satisfaction with Life Scale (SWLS). While controlling for known predictors of outcome, the relationship of overall comorbidity burden to psychological outcomes was examined cross-sectionally using generalized linear regression at 2 and 5 years post-TBI. Lasso regularization was used to examine relationships of specific comorbid conditions to outcome. Results: Greater comorbidity burden was significantly associated with lower satisfaction with life at 2 and 5 years post-TBI and was associated with greater depressive symptomatology at 5 years post-TBI. Chronic pain was associated with lower satisfaction with life and greater depressive symptoms at both 2- and 5-year follow-up. Sleep apnea was associated with lower satisfaction with life and greater depressive symptoms at 5-year follow-up. Rheumatoid arthritis was associated with lower satisfaction with life and lower levels of perceived improvement in health and well-being at the 5-year follow-up. Implications: Results suggest that medical comorbidities may have a cumulative impact on adverse psychological health outcomes in chronic stages of TBI. This study further highlights the complexity of patients with TBI and the importance of identifying medical comorbidities as they provide potential targets for intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).