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Association of Posttraumatic Stress Symptom Severity With Health-Related Quality of Life and Self-Reported Functioning Across 12 Months After Severe Traumatic Brain Injury
Authors:Colin M. Bosma  Nashwa Mansoor  Chiara S. Haller
Affiliation:1. Department of Psychology, University of Maine, Orono, ME;2. Department of Psychology, Harvard University, Cambridge, MA;3. Division of Public Psychiatry, Massachusetts Mental Health Center, Boston, MA
Abstract:

Objective

To investigate the relation between posttraumatic stress (PTS) symptom severity and health-related quality of life (HRQoL) after severe traumatic brain injury (TBI).

Design

Longitudinal prospective multicenter, cohort study on severe TBI in Switzerland (2007–2011).

Setting

Hospital, rehabilitation unit, and/or patient’s living facility.

Participants

Patients with severe TBI (N=109) were included in the analyses. Injury severity was determined using the Abbreviated Injury Score of the head region after clinical assessment and initial computed tomography scan.

Interventions

Not applicable.

Main Outcome Measures

HRQoL (Medical Outcomes Study 12-Item Short-Form Health Survey Physical and Mental Component Summaries) and self-reported emotional, cognitive, and interpersonal functioning (Patient Competency Rating Scale for Neurorehabilitation).

Results

Multilevel models for patients >50 and ≤50 years of age revealed significant negative associations between PTS symptom severity and interpersonal functioning (P<.001 and P=.002), respectively. Among patients ≤50 years of age, PTS symptom severity was significantly associated with total functioning (P=.001) and emotional functioning (P<.001). Among all patients, PTS symptom severity was significantly associated with cognitive functioning (P<.001) and mental HRQoL (P=.01).

Conclusions

Findings indicate that PTS symptoms after severe TBI are negatively associated with HRQoL and emotional, cognitive, and interpersonal functioning.
Keywords:Quality of life  Rehabilitation  Stress disorders, post-traumatic  Traumatic brain injury  DSM-IV  GCS  Glasgow Coma Scale  HAIS  Abbreviated Injury Scale of the head region  HRQoL  health-related quality of life  MCS  Mental Component Summary  PCS  Physical Component Summary  PCRS-NR  Patient Competency Rating Scale for Neurorehabilitation  PEBITA TRAST-MI  Patient-relevant Endpoints after Brain Injury from Traumatic Accidents Trajectories of Recovery After Severe TBI - Matter in Families  PTS  posttraumatic stress  PTSD  posttraumatic stress disorder  SF-12  Medical Outcomes Study 12-Item Short-Form Health Survey  TBI  traumatic brain injury
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