Neuropsychiatric Sequelae of Brain Injury is Significant, Regardless of Injury Severity
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Objective
Brain Injury is the leading cause of death and disability for Canadians under 40 years old. To better understand chronic neuropsychiatric sequelae within our local brain injury population, a retrospective chart review was carried out for all Acquired Brain Injury (ABI) physiatry clinic attendees between November 2014 and December 2021 (n=220) at our public rehabilitation hospital in Southeastern Ontario.
Methods
All cases were classified into four subgroups: multiple mild, mild, moderate-severe traumatic brain injury (TBI), and non-TBI. Comparison of depression, anxiety and concussion symptoms were made between subgroups using scores from the Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7) and Rivermead Post-Concussion Symptoms Questionnaire, (RPQ), self-reported physical symptoms, sleep disturbance and medications were also investigated. Analysis was repeated with six subgroups, created by further separating cases into moderate and severe TBI where possible.
Results
Almost all brain-injury subgroups had moderately severe depression, anxiety and post-concussion symptoms but multiple mild-TBI most frequently self-reported cognitive, neuropsychiatric and sleep disturbance issues. Moderately severe TBI most frequently self-reported physical complaints and sleep disturbance (60%, n=9), although none (0%, n=0) were prescribed sleep medication. Mild TBI (n=60) reported sleep disturbance less frequently (42%, n=25) than moderately severe TBI but 22% (n=13) were prescribed sleep medication.
Conclusion
All brain injury subgroups had similar levels of moderately severe neuropsychiatric sequelae; including depression, anxiety and post-concussion symptoms. Multiple mild-TBI had the most self-reported symptoms; while moderately severe TBI were most likely to report physical complaints and sleep disturbance.