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Mamman R, Grewal J, Garrone JN, Schmidt J. Biopsychosocial factors of quality of life in individuals with moderate to severe traumatic brain injury: a scoping review. Qual Life Res 2023:10.1007/s11136-023-03511-0. [PMID: 37925675 DOI: 10.1007/s11136-023-03511-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE Individuals with moderate to severe traumatic brain injury (TBI) experience changes in their quality-of-life (QOL) post-injury. Given the vast literature that exists about QOL after TBI, a scoping review was performed to identify the different biopsychosocial factors that affect a person's QOL after a moderate to severe TBI. METHODS A scoping review was conducted using the following electronic databases: MEDLINE, CINAHL, Embase, and PsycINFO. Terms relating to TBI and QOL were used. RESULTS There were 7576 articles obtained from the databases, resulting in 535 full-text articles. Ultimately, 52 articles were extracted, which consisted of biopsychosocial QOL factors after TBI. The biopsychosocial factors of QOL after TBI included 19 biological factors (i.e., sex, TBI severity, cognition), 16 psychological factors (i.e., depression, self-efficacy, coping styles), and 19 social factors (i.e., employment, social participation, social support). Factors such as fatigue, self-awareness, transition, and discharge from hospitals are known issues in TBI literature but were minimally reported in studies in this review, identifying them as potential gaps in research. CONCLUSION Identifying biopsychosocial factors relating to QOL after TBI can enable health services to develop targeted rehabilitation programs for individuals with TBI.
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Affiliation(s)
- Rinni Mamman
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Jasleen Grewal
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | | | - Julia Schmidt
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada.
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Abstract
OBJECTIVE Depression is among the most pervasive and debilitating neuropsychiatric sequelae experienced by patients following a traumatic brain injury (TBI). While the individual mechanisms underlying depression and TBI have been widely studied, the neurobiological bases of depression after TBI remain largely unknown. This article highlights the potential mechanisms of action implicated in depression after TBI. RESULTS We review putative mechanisms of action including neuroinflammation, neuroendocrine dysregulation, metabolic abnormalities, and neurotransmitter and circuitry dysfunction. We also identify the current limitations in the field and propose directions for future research. CONCLUSION An improved understanding of the underlying mechanisms will aid the development of precision-guided and personalized treatments for patients suffering from depression after TBI.
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Affiliation(s)
- Aava Bushra Jahan
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, US.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, US
| | - Kaloyan Tanev
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, US
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3
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Yoo SD, Park EJ. Association of Depressive and Somatic Symptoms with Heart Rate Variability in Patients with Traumatic Brain Injury. J Clin Med 2022; 12:jcm12010104. [PMID: 36614905 PMCID: PMC9821673 DOI: 10.3390/jcm12010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Depressive and somatic symptoms are common after traumatic brain injury (TBI). Depression after TBI can relate to worsened cognitive functioning, functional impairment, higher rates of suicide attempts, and larger health care costs. Heart rate variability (HRV) represents the activity of the autonomic nervous system (ANS), which regulates almost all vascular, visceral, and metabolic functions. Several studies show a correlation between HRV, depression, and somatic symptoms in other diseases. However, studies on autonomic dysfunction, depression, and somatic symptoms in TBI patients are lacking. This study investigated the association between reduced ANS function, depression, and somatic symptoms in TBI patients. We retrospectively recruited 136 TBI patients who underwent 24 h ambulatory Holter electrocardiography to measure autonomic dysfunction within 1 month of onset. Patients who used BDI and PHQ-15 to evaluate depressive and somatic symptoms were included. Using Pearson's correlation analysis and multiple linear regression, the association between HRV parameters and BDI and PHQ-15 was determined. The HRV parameters and BDI and PHQ-15 showed statistical significance. In addition, HRV was shown to be a significantly associated factor of BDI and PHQ-15. HRV was associated with depressive and somatic symptom severity in TBI patients. Additionally, autonomic dysfunction may serve as an associated factor of depressive and somatic symptoms in patients with TBI.
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Affiliation(s)
| | - Eo Jin Park
- Correspondence: ; Tel.: +82-2-440-7246; Fax: +82-2-440-7171
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4
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Roy D, Ghosh A, Yan H, Leoutsakos JM, Rao V, Peters ME, Van Meter TE, Sair H, Falk H, Korley FK, Bechtold KT. Prevalence and Correlates of Depressive Symptoms Within 6 Months After First-Time Mild Traumatic Brain Injury. J Neuropsychiatry Clin Neurosci 2022; 34:367-377. [PMID: 35306831 DOI: 10.1176/appi.neuropsych.21080207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Depressive symptoms are among the most common neuropsychiatric sequelae of mild traumatic brain injury (mTBI). Very few studies have compared correlates of depressive symptoms within the first 6 months of injury in cohorts experiencing their first TBI. The authors investigated whether the correlates of depressive symptoms (being female, older, lower education, having brain lesions, experiencing worse postconcussive symptoms, and incomplete functional recovery) that have been established in populations with moderate to severe TBI were the same for individuals with first-time mTBI within the first 6 months of recovery. METHODS Two hundred seventeen individuals with first-time mTBI were divided into subgroups-new-onset depressive symptoms, recurrent depressive symptoms, prior depression history only, and never depressed-and compared on clinical and demographic variables and the presence of postconcussive symptoms and functional recovery at 3 and 6 months. RESULTS New-onset depressive symptoms developed in 12% of the cohort, whereas 11% of the cohort had recurrent depressive symptoms. Both depressive symptoms groups were more likely to comprise women and persons of color and were at higher risk for clinically significant postconcussive symptoms and incomplete functional recovery for the first 6 months postinjury. CONCLUSIONS Presence of depressive symptoms after first-time mTBI was associated with persistent postconcussive symptoms and incomplete functional recovery in the first 6 months. Adding to the existing literature, these findings identified correlates of depressive symptom development and poor outcomes after mTBI, thus providing further evidence that mTBI may produce persistent symptoms and functional limitations that warrant clinical attention.
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Affiliation(s)
- Durga Roy
- Departments of Psychiatry and Behavioral Sciences (Roy, Yan, Leoutsakos, Rao, Peters) and Physical Medicine and Rehabilitation (Bechtold), Johns Hopkins University, Baltimore; Department of Pharmacology and Physiology, Georgetown University, Washington, DC (Ghosh); ImmunArray, Inc., Richmond, Virginia (Van Meter); University of Michigan Medical School, Ann Arbor (Falk, Korley)
| | - Anjik Ghosh
- Departments of Psychiatry and Behavioral Sciences (Roy, Yan, Leoutsakos, Rao, Peters) and Physical Medicine and Rehabilitation (Bechtold), Johns Hopkins University, Baltimore; Department of Pharmacology and Physiology, Georgetown University, Washington, DC (Ghosh); ImmunArray, Inc., Richmond, Virginia (Van Meter); University of Michigan Medical School, Ann Arbor (Falk, Korley)
| | - Haijuan Yan
- Departments of Psychiatry and Behavioral Sciences (Roy, Yan, Leoutsakos, Rao, Peters) and Physical Medicine and Rehabilitation (Bechtold), Johns Hopkins University, Baltimore; Department of Pharmacology and Physiology, Georgetown University, Washington, DC (Ghosh); ImmunArray, Inc., Richmond, Virginia (Van Meter); University of Michigan Medical School, Ann Arbor (Falk, Korley)
| | - Jeannie-Marie Leoutsakos
- Departments of Psychiatry and Behavioral Sciences (Roy, Yan, Leoutsakos, Rao, Peters) and Physical Medicine and Rehabilitation (Bechtold), Johns Hopkins University, Baltimore; Department of Pharmacology and Physiology, Georgetown University, Washington, DC (Ghosh); ImmunArray, Inc., Richmond, Virginia (Van Meter); University of Michigan Medical School, Ann Arbor (Falk, Korley)
| | - Vani Rao
- Departments of Psychiatry and Behavioral Sciences (Roy, Yan, Leoutsakos, Rao, Peters) and Physical Medicine and Rehabilitation (Bechtold), Johns Hopkins University, Baltimore; Department of Pharmacology and Physiology, Georgetown University, Washington, DC (Ghosh); ImmunArray, Inc., Richmond, Virginia (Van Meter); University of Michigan Medical School, Ann Arbor (Falk, Korley)
| | - Matthew E Peters
- Departments of Psychiatry and Behavioral Sciences (Roy, Yan, Leoutsakos, Rao, Peters) and Physical Medicine and Rehabilitation (Bechtold), Johns Hopkins University, Baltimore; Department of Pharmacology and Physiology, Georgetown University, Washington, DC (Ghosh); ImmunArray, Inc., Richmond, Virginia (Van Meter); University of Michigan Medical School, Ann Arbor (Falk, Korley)
| | - Timothy E Van Meter
- Departments of Psychiatry and Behavioral Sciences (Roy, Yan, Leoutsakos, Rao, Peters) and Physical Medicine and Rehabilitation (Bechtold), Johns Hopkins University, Baltimore; Department of Pharmacology and Physiology, Georgetown University, Washington, DC (Ghosh); ImmunArray, Inc., Richmond, Virginia (Van Meter); University of Michigan Medical School, Ann Arbor (Falk, Korley)
| | - Haris Sair
- Departments of Psychiatry and Behavioral Sciences (Roy, Yan, Leoutsakos, Rao, Peters) and Physical Medicine and Rehabilitation (Bechtold), Johns Hopkins University, Baltimore; Department of Pharmacology and Physiology, Georgetown University, Washington, DC (Ghosh); ImmunArray, Inc., Richmond, Virginia (Van Meter); University of Michigan Medical School, Ann Arbor (Falk, Korley)
| | - Hayley Falk
- Departments of Psychiatry and Behavioral Sciences (Roy, Yan, Leoutsakos, Rao, Peters) and Physical Medicine and Rehabilitation (Bechtold), Johns Hopkins University, Baltimore; Department of Pharmacology and Physiology, Georgetown University, Washington, DC (Ghosh); ImmunArray, Inc., Richmond, Virginia (Van Meter); University of Michigan Medical School, Ann Arbor (Falk, Korley)
| | - Frederick K Korley
- Departments of Psychiatry and Behavioral Sciences (Roy, Yan, Leoutsakos, Rao, Peters) and Physical Medicine and Rehabilitation (Bechtold), Johns Hopkins University, Baltimore; Department of Pharmacology and Physiology, Georgetown University, Washington, DC (Ghosh); ImmunArray, Inc., Richmond, Virginia (Van Meter); University of Michigan Medical School, Ann Arbor (Falk, Korley)
| | - Kathleen T Bechtold
- Departments of Psychiatry and Behavioral Sciences (Roy, Yan, Leoutsakos, Rao, Peters) and Physical Medicine and Rehabilitation (Bechtold), Johns Hopkins University, Baltimore; Department of Pharmacology and Physiology, Georgetown University, Washington, DC (Ghosh); ImmunArray, Inc., Richmond, Virginia (Van Meter); University of Michigan Medical School, Ann Arbor (Falk, Korley)
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Abstract
Neurobehavioral sequelae after mild traumatic brain injury are multifactorial, often necessitating a multidisciplinary approach. Neurobehavioral sequelae generally resolve within 3 months; when more persistent, a search for contributing factors beyond a brain injury should be done. To accomplish this, a systematic and comprehensive evaluation is recommended to place the complaint in context of the patient's premorbid state. The treatment of neurobehavioral sequelae cannot be accomplished without a clear understanding of the underlying cause, and the treatment must be placed within a patient's social and functional framework. Normalizing the experience through education of patients and their families facilitates recovery.
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Affiliation(s)
- Megan E Solberg
- Department of Counseling Psychology, Morgridge College of Education, University of Denver, 1999 East Evans Avenue, Denver, CO 80208, USA
| | - Silvana Riggio
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA; Department of Neurology, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA; Department of Psychiatry, James J. Peters VAMC, 130 West Kingsbridge Road, Bronx, NY, USA.
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6
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Aschenbrenner S, Schilling TM, Grossmann J, Heck T, Bossert M. [Mental disorders after acquired CNS damage]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 89:114-129. [PMID: 33684946 DOI: 10.1055/a-1309-0725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Mental disorders are a frequent consequence of acquired central nervous damage. If not recognized and treated early, they have a negative impact on the course of neurological rehabilitation. This article deals with the diagnosis and treatment of mental disorders after acquired damage to the central nervous system.
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7
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Fakhoury M, Shakkour Z, Kobeissy F, Lawand N. Depression following traumatic brain injury: a comprehensive overview. Rev Neurosci 2020; 32:289-303. [PMID: 33661587 DOI: 10.1515/revneuro-2020-0037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 10/21/2020] [Indexed: 12/19/2022]
Abstract
Traumatic brain injury (TBI) represents a major health concern affecting the neuropsychological health; TBI is accompanied by drastic long-term adverse complications that can influence many aspects of the life of affected individuals. A substantial number of studies have shown that mood disorders, particularly depression, are the most frequent complications encountered in individuals with TBI. Post-traumatic depression (P-TD) is present in approximately 30% of individuals with TBI, with the majority of individuals experiencing symptoms of depression during the first year following head injury. To date, the mechanisms of P-TD are far from being fully understood, and effective treatments that completely halt this condition are still lacking. The aim of this review is to outline the current state of knowledge on the prevalence and risk factors of P-TD, to discuss the accompanying brain changes at the anatomical, molecular and functional levels, and to discuss current approaches used for the treatment of P-TD.
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Affiliation(s)
- Marc Fakhoury
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Zaynab Shakkour
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Firas Kobeissy
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nada Lawand
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Department of Neurology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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8
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Hellewell SC, Beaton CS, Welton T, Grieve SM. Characterizing the Risk of Depression Following Mild Traumatic Brain Injury: A Meta-Analysis of the Literature Comparing Chronic mTBI to Non-mTBI Populations. Front Neurol 2020; 11:350. [PMID: 32508733 PMCID: PMC7248359 DOI: 10.3389/fneur.2020.00350] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 04/08/2020] [Indexed: 12/11/2022] Open
Abstract
Objective: Mild traumatic brain injury (mTBI) is associated with depressed mood acutely post-injury, but there is little evidence regarding long-term depression. The aim of this study was to determine the odds ratio (OR) of depression chronically following mTBI. Methods: We searched Medline (PubMed), ProQuest, and Web of Science from date of database creation to January 23, 2019, for eligible studies examining depression at least 6 months post-injury in adult subjects with mTBI of any etiology, including civilians and military. Three authors independently reviewed titles and abstracts for study eligibility. Data were extracted and collated by two investigators. Risk of bias was assessed with the SIGN methodology. Study data were pooled using random-effects meta-analysis. The primary exposure was mTBI, and the primary outcome was depression. Secondary exploratory variables were time of assessment, age at injury, age at assessment, sex, and etiology. Results: We included 47 cross-sectional studies (n = 25,103 mTBI and 29,982 control), 26 cohort studies (n = 70,119 mTBI, 262,034 control), four prospective observational studies (n = 1,058 mTBI and 733 control), two prospective longitudinal studies (n = 119 mTBI, 81 control), two case-control studies (n = 56 mTBI, 56 control), and one randomized controlled trial (n = 252 mTBI, 3,214 control). mTBI was associated with a 3.29-fold increased risk of depression (OR 3.29, 95% CI 2.68–4.03, I2 = 96%). The OR for depression did not change when subjects were assessed at 6–12 months (OR 2.43, 1.45–4.07), years 1–2 (OR 4.12, 2.10–8.07); 2–10 (OR 3.28, 2.42–4.46), or 10+ (OR 3.42, 1.51–7.77). Similar risk of depression was sustained across different age at injury (<25: OR 2.26, 1.82–2.81; 25–35: OR 4.67, 3.06–7.14; >35: OR 2.69, 1.42–5.10) and different age at assessment (<40 years: OR 3.14, 2.48–3.99; >40 years: OR 4.57, 2.54–8.24). Female sex had a non-significant increase in OR (OR 19.97, 2.39–166.93) compared to male (OR 3.0, 2.33–3.86). mTBI etiology had no impact on depression. Conclusions: Those experiencing mTBI are more than three times more likely to experience depression compared to those without a history of mTBI, and this risk remains decades beyond the mTBI event. Future longitudinal studies are needed to identify and mitigate this risk.
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Affiliation(s)
- Sarah C Hellewell
- Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Caerwen S Beaton
- Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Thomas Welton
- Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Stuart M Grieve
- Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Department of Radiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
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9
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Lu YC, Wu MK, Zhang L, Zhang CL, Lu YY, Wu CH. Association between suicide risk and traumatic brain injury in adults: a population based cohort study. Postgrad Med J 2020; 96:747-752. [PMID: 32015186 PMCID: PMC7788485 DOI: 10.1136/postgradmedj-2019-136860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 12/01/2019] [Accepted: 12/31/2019] [Indexed: 12/16/2022]
Abstract
Background Traumatic brain injury (TBI) is a major cause of death and disability worldwide, and its treatment is potentially a heavy economic burden. Suicide is another global public health problem and the second leading cause of death in young adults. Patients with TBI are known to have higher than normal rates of non-fatal deliberate self-harm, suicide and all-cause mortality. The aim of this study was to explore the association between TBI and suicide risk in a Chinese cohort. Method This study analysed data contained in the Taiwan National Health Insurance Research Database for 17 504 subjects with TBI and for 70 016 subjects without TBI matched for age and gender at a ratio of 1 to 4. Cox proportional hazard regression analysis was used to estimate subsequent suicide attempts in the TBI group. Probability of attempted suicide was determined by Kaplan-Meier method. Results The overall risk of suicide attempts was 2.23 times higher in the TBI group compared with the non-TBI group (0.98 vs 0.29 per 1000 person-years, respectively) after adjustment for covariates. Regardless of gender, age or comorbidity, the TBI group tended to have more suicide attempts, and the risk attempted suicide increased with the severity of TBI. Depression and alcohol attributed disease also increased the risk of attempted suicide in the TBI group. Conclusion Suicide is preventable if risk factors are recognised. Hence, TBI patients require special attention to minimise their risk of attempted suicide.
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Affiliation(s)
- Yueh-Chien Lu
- Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Kung Wu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Li Zhang
- Department of Neurosurgery, The Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, China
| | - Cong-Liang Zhang
- Department of Cardiology, Hebei Quyang Renji Hospital, Quyang, China
| | - Ying-Yi Lu
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chieh-Hsin Wu
- Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan .,Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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10
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Fedele B, Williams G, McKenzie D, Sutherland E, Olver J. Subacute sleep disturbance in moderate to severe traumatic brain injury: a systematic review. Brain Inj 2019; 34:316-327. [PMID: 31774695 DOI: 10.1080/02699052.2019.1695288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: This systematic review evaluated subacute sleep disturbance following moderate to severe traumatic brain injury (TBI) and the impact of secondary factors such as mood or pain.Methods: A comprehensive search strategy was applied to nine databases. Inclusion criteria included: adults ≥18 years, moderate and severe TBI and within 3 months of injury. Eligible studies were critically appraised using the McMaster Quantitative Critical Review Form. Study characteristics, outcomes, and methodological quality were synthesized. This systematic review was registered with PROSPERO (Registration number: CRD42018087799).Results: Ten studies were included. Research identified early-onset sleep disturbances; characterized as fragmented sleep periods and difficulty initiating sleep. Alterations to sleep architecture (e.g. rapid eye movement sleep) were reported. Sleep disturbance appears to associate with alterations of consciousness. Sleep disturbance tended to be particularly increased during the phase of post-traumatic amnesia (PTA) (78.7%).Conclusions: There is a limited amount of research available, which has inherent measurement and sample size limitations. The gold standard for measuring sleep (polysomnography) was rarely utilized, which may affect the detection of sleep disturbance and sleep architecture. Secondary factors potentially influencing sleep were generally not reported. Further evaluation on associations between sleep and PTA is needed.
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Affiliation(s)
- Bianca Fedele
- Department of Rehabilitation, Epworth HealthCare, Melbourne, Australia.,Department of Rehabilitation, Epworth Monash Rehabilitation Medicine Unit (EMReM), Melbourne, Australia.,School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Gavin Williams
- Department of Rehabilitation, Epworth Monash Rehabilitation Medicine Unit (EMReM), Melbourne, Australia.,Department of Physiotherapy, The University of Melbourne, Melbourne, Australia
| | - Dean McKenzie
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.,Research Development and Governance Unit, Epworth HealthCare, Melbourne, Australia
| | - Edwina Sutherland
- Department of Rehabilitation, Epworth HealthCare, Melbourne, Australia
| | - John Olver
- Department of Rehabilitation, Epworth HealthCare, Melbourne, Australia.,Department of Rehabilitation, Epworth Monash Rehabilitation Medicine Unit (EMReM), Melbourne, Australia.,School of Clinical Sciences, Monash University, Melbourne, Australia
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11
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Kim S, Mortera M, Hu X, Krishnan S, Hoffecker L, Herrold A, Terhorst L, King L, Machtinger J, Zumsteg JM, Negm A, Heyn P. Overview of pharmacological interventions after traumatic brain injuries: impact on selected outcomes. Brain Inj 2019; 33:442-455. [DOI: 10.1080/02699052.2019.1565896] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Sonya Kim
- Department of Neurology and Department of Rehabilitation Medicine, NYU School of Medicine, New York, USA
| | - Marianne Mortera
- NYU Steinhardt, Department of Occupational Therapy, New York University, New York, USA
| | - Xiaolei Hu
- Department of Community Medicine and Rehabilitation, Umeå University, Sweden
| | - Shilpa Krishnan
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, Georgia, USA
| | - Lilian Hoffecker
- Health Sciences Library, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Amy Herrold
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr., VA Hospital, Hines, Illinois, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, School of Health and Rehabilitation Services, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Laurie King
- Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - Joseph Machtinger
- Department of Neurology, Division of Multiple Sclerosis, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jennifer M. Zumsteg
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Ahmed Negm
- School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, USA
| | - Patricia Heyn
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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12
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Leong Bin Abdullah MFI, Ng YP, Sidi HB. Depression and anxiety among traumatic brain injury patients in Malaysia. Asian J Psychiatr 2018; 37:67-70. [PMID: 30144779 DOI: 10.1016/j.ajp.2018.08.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/25/2018] [Accepted: 08/16/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Depression and anxiety are common psychiatric sequelae of traumatic brain injury (TBI). However, there is lack of data on comorbid depression and anxiety, and depression and anxiety in TBI patients were often evaluated using non-validated diagnostic tools. This study aims to determine the rates, their comorbidity, and factors associated with depressive and anxiety disorders in TBI patients. METHODS In this cross-sectional study, 101 TBI patients were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders to assess the rates of depressive and anxiety disorders after TBI. The association of socio-demographic and clinical factors with depressive and anxiety disorders were determined using Pearson's Chi-Square test. RESULTS A total of 25% of TBI patients (n = 25/101) were diagnosed with depressive disorders, of which 15% had major depressive disorder (n = 15/101) and 10% had minor depression (n = 10/101). Fourteen percent of TBI patients had anxiety disorders (n = 14/101), of which post-traumatic stress disorder (PTSD) was the commonest anxiety disorder (9%, n = 9/101). Seven percent of TBI patients (n = 7/101) had comorbid depressive and anxiety disorders. The only factor associated with depressive disorder was the duration of TBI (≥ 1 year) while the only factor associated with anxiety disorder was the mechanism of trauma (assault). CONCLUSION Major depressive disorder, minor depression and PTSD are common psychiatric complications of TBI. Clinicians should screen for depressive and anxiety disorders in TBI patients, particularly those with ≥1 year of injury and had sustained TBI from assault.
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Affiliation(s)
| | - Yin Ping Ng
- Department of Psychiatry, RCSI & UCD Malaysia Campus, 4 Jalan Sepoy Lines, 10450 George Town, Pulau Pinang, Malaysia.
| | - Hatta Bin Sidi
- Department of Psychiatry, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
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