Abstract
Objective
To examine heterogeneity in the temporal patterns of depression and participation
over the first 2 years post traumatic brain injury (TBI).
Design
Observational prospective longitudinal study.
Setting
Inpatient rehabilitation centers, with 1- and 2-year follow-up conducted primarily
by telephone.
Participants
Persons with TBI (N=2307) enrolled in the Traumatic Brain Injury Model Systems database,
followed at 1 and 2 years post injury.
Interventions
Not applicable.
Main Outcome Measure
Patient Health Questionnaire-9 (PHQ-9) and Participation Assessment With Recombined
Tools–Objective (PART-O).
Results
Using latent class modeling we examined heterogeneity in the longitudinal relationship
between PHQ-9 and PART-O. The identified 6 classes were most distinct in terms of
(1) level of PHQ-9 score and (2) association between the year 1 PART-O score and year
2 PHQ-9 score. For most participants, PART-O at year 1 predicted PHQ-9 at year 2 more
than the reverse. However, there was a subgroup of participants that demonstrated
the reverse pattern, PHQ-9 predicting later PART-O, who were on average, older and
in the “other” employment category.
Conclusions
Results suggest that links between participation and depression are stronger for some
people living with TBI than for others and that variation in the temporal sequencing
of these 2 constructs is associated with demographic characteristics. These findings
illustrate the value in accounting for population heterogeneity when evaluating temporal
among outcome domains.
Keywords
List of abbreviations:
BIC (Bayesian information criterion), PART-O (Participation Assessment With Recombined Tools–Objective), PHQ-9 (Patient Health Questionnaire-9), PTA (posttraumatic amnesia), 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: July 09, 2020
Footnotes
Supported in part by the National Institutes of Health (grant no. R03HD093992, PI: Rabinowitz) and the National Institute on Disability, Independent Living, and Rehabilitation Research (grant nos. 90DPTB0004, PI: Rabinowitz; 90DPTB0011, PI: Giacino; 90DPTB0013, PI: Bell; 90DPTB0008, PI: Hoffman).
Identification
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© 2020 by the American Congress of Rehabilitation Medicine
