Psychiatric disorders and functional disability in outpatients with traumatic brain injuries

Abstract

Objective: This study examined psychiatric sequelae of traumatic brain injuries in outpa-tients and their relation to functional disability. Method: Fifty consecutive outpatients with traumatic brain injuries who came to a brain injury rehabilitation clinic for initial evaluation were examined for DSM-III-R diagnoses with the use of the National Institute of Mental Health Diagnostic Interview Schedule. The patients completed the Medical Outcomes Study Health Survey to assess functional disability and a questionnaire to assess postconcussion symptoms and self-perceptions ofthe severity oftheir brain injuries and cognitive functioning. Results: Thirteen (26%) of the patients had current major depression, and an additional 14 (28%) reporteda first-onset major depressive episode after the injury that had resolved. Twelve (24%) had current generalized anxiety disorder, and four (8%) reported current substance abuse. The group with depression and/or anxiety was significantly more impaired than the nondepressed/nonanxious patients according to the Medical Outcomes Study Health Survey measures of emotional role functioning, mental health, and general health perceptions. The depressed/anxious group also rated their injuries as significantly more severe and their cogni-tive functioning as significantly worse, despite the lack of significant differences in objectiv