To examine heterogeneity in the temporal patterns of depression and participation over the first 2 years post traumatic brain injury (TBI).
Observational prospective longitudinal study.
Inpatient rehabilitation centers, with 1- and 2-year follow-up conducted primarily by telephone.
Persons with TBI (N=2307) enrolled in the Traumatic Brain Injury Model Systems database, followed at 1 and 2 years post injury.
Main Outcome Measure
Patient Health Questionnaire-9 (PHQ-9) and Participation Assessment With Recombined Tools–Objective (PART-O).
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.
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.
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)
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Published online: July 09, 2020
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).
© 2020 by the American Congress of Rehabilitation Medicine