Abstract
Objective
To assess the prevalence of pain, depression, and comorbid pain and depression among
a civilian sample of persons with traumatic brain injury (TBI).
Design
Longitudinal survey design with 1-year follow-up.
Setting
Inpatient rehabilitation and the community.
Participants
Participants (N=158) admitted to inpatient rehabilitation after moderate to severe
TBI.
Interventions
Not applicable.
Main Outcome Measures
Depression was assessed with the Patient Health Questionnaire-9 (PHQ-9); pain was
assessed with a numerical rating scale from 0 (no pain) to 10 (worst pain). Participants
who reported average pain ≥4 were classified as having pain, and participants with
PHQ-9 scores ≥10 were classified as depressed.
Results
Both pain and depression were more prevalent at baseline assessment (pain: 70%; depression:
31%) than at year 1 (pain: 34%; depression: 22%). Comorbid pain and depression declined
from 27% at baseline to 18% at year 1. Pain was significantly associated with depression
at baseline (relative risk: 2.62, P=.003) and at year 1 (relative risk: 7.98, P<.001).
Conclusions
Pain and depression are common and frequently co-occur in persons with TBI. Although
their frequency declined over the first year after injury, the strength of their association
increased. Assessment and treatment of both conditions simultaneously may lead to
improved outcomes, both early after TBI and over time.
Keywords
List of abbreviations:
PHQ-9 (Patient Health Questionnaire-9), TBI (traumatic brain injury), TBIMS (Traumatic Brain Injury Model Systems)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 21, 2014
Footnotes
Supported by the National Institute on Disability and Rehabilitation Research Traumatic Brain Injury Model Systems (grant no. H133A070032) and Department of Defense Congressionally Directed Medical Research Programs (grant no. W81XWH-12-2-0109).
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
