학술논문

Long-Term Psychiatric Outcomes in Adults with History of Pediatric Traumatic Brain Injury
Document Type
article
Source
Journal of Neurotrauma. 38(11)
Subject
Childhood Injury
Pediatric
Clinical Research
Physical Injury - Accidents and Adverse Effects
Traumatic Head and Spine Injury
Brain Disorders
Traumatic Brain Injury (TBI)
Neurosciences
Unintentional Childhood Injury
Mental health
Injuries and accidents
Adolescent
Adult
Age Factors
Brain Injuries
Traumatic
Case-Control Studies
Child
Cohort Studies
Female
Hospitalization
Humans
Male
Mental Disorders
Risk Factors
Time Factors
Trauma Severity Indices
adolescent TBI
child TBI
long-term psychiatric outcome
psychiatric disorder
traumatic brain injury
Clinical Sciences
Neurology & Neurosurgery
Language
Abstract
The objective of the study was to compare psychiatric outcomes in adults with and without history of pediatric traumatic brain injury (TBI). Youth ages 6 to 14 years hospitalized for TBI from 1992 to 1994 were assessed at baseline and at 3, 6, 12, and 24 months post-injury. In the current study, psychiatric assessments were repeated at 24 years post-injury with the same cohort, now adults ages 29 to 39 years. A control group of healthy adults also was recruited for one-time cross-sectional assessments. Outcome measures included: 1) presence of a psychiatric disorder since the 24-month assessment not present before the TBI ("novel psychiatric disorder," NPD), or in the control group, the presence of a psychiatric disorder that developed after the mean age of injury of the TBI group plus 2 years; and 2) Time-to-Event for onset of an NPD during the same time periods. In the TBI group, NPDs were significantly more common, and presence of a current NPD was significantly predicted by presence of a pre-injury lifetime psychiatric disorder and by abnormal day-of-injury computed tomography (CT) scan. Compared with controls, the TBI group also had significantly shorter Time-to-Event for onset of any NPD. These findings demonstrate that long-term psychiatric outcomes in adults previously hospitalized for pediatric TBI are significantly worse when compared with adult controls without history of pediatric TBI, both in terms of prevalence and earlier onset of NPD. Further, in the TBI group, long-term NPD outcome is predicted independently by presence of pre-injury psychiatric disorder and abnormal day-of-injury CT scan.