Post-traumatic epilepsy associations with mental health outcomes in the first two years after moderate to severe TBI: A TBI Model Systems analysis

Shannon B. Juengst, Amy K. Wagner, Anne C. Ritter, Jerzy P. Szaflarski, William C. Walker, Ross D. Zafonte, Allen W. Brown, Flora Hammond, Mary Jo Pugh, Timothy Shea, Jason W. Krellman, Tamara Bushnik, Patricia M. Arenth

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose Research suggests that there are reciprocal relationships between mental health (MH) disorders and epilepsy risk. However, MH relationships to post-traumatic epilepsy (PTE) have not been explored. Thus, the objective of this study was to assess associations between PTE and frequency of depression and/or anxiety in a cohort of individuals with moderate-to-severe TBI who received acute inpatient rehabilitation. Methods Multivariate regression models were developed using a recent (2010–2012) cohort (n = 867 unique participants) from the TBI Model Systems (TBIMS) National Database, a time frame during which self-reported seizures, depression [Patient Health Questionnaire (PHQ)-9], and anxiety [Generalized Anxiety Disorder (GAD-7)] follow-up measures were concurrently collected at year-1 and year-2 after injury. Results PTE did not significantly contribute to depression status in either the year-1 or year-2 cohort, nor did it contribute significantly to anxiety status in the year-1 cohort, after controlling for other known depression and anxiety predictors. However, those with PTE in year-2 had 3.34 times the odds (p = .002) of having clinically significant anxiety, even after accounting for other relevant predictors. In this model, participants who self-identified as Black were also more likely to report clinical symptoms of anxiety than those who identified as White. PTE was the only significant predictor of comorbid depression and anxiety at year-2 (Odds Ratio 2.71; p = 0.049). Conclusions Our data suggest that PTE is associated with MH outcomes 2 years after TBI, findings whose significance may reflect reciprocal, biological, psychological, and/or experiential factors contributing to and resulting from both PTE and MH status post-TBI. Future work should consider temporal and reciprocal relationships between PTE and MH as well as if/how treatment of each condition influences biosusceptibility to the other condition.

Original languageEnglish (US)
Pages (from-to)240-246
Number of pages7
JournalEpilepsy and Behavior
Volume73
DOIs
StatePublished - Aug 1 2017

Fingerprint

Mental Health Associations
Post-Traumatic Epilepsy
Systems Analysis
Anxiety
Mental Health
Depression
Anxiety Disorders
Mental Disorders
Health Status
Inpatients
Epilepsy
Seizures
Rehabilitation
Odds Ratio
Databases
Psychology

Keywords

  • Anxiety
  • Depression
  • Mental health disorders
  • Post-traumatic epilepsy
  • Traumatic brain injury
  • Traumatic brain injury model system

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

Cite this

Post-traumatic epilepsy associations with mental health outcomes in the first two years after moderate to severe TBI : A TBI Model Systems analysis. / Juengst, Shannon B.; Wagner, Amy K.; Ritter, Anne C.; Szaflarski, Jerzy P.; Walker, William C.; Zafonte, Ross D.; Brown, Allen W.; Hammond, Flora; Pugh, Mary Jo; Shea, Timothy; Krellman, Jason W.; Bushnik, Tamara; Arenth, Patricia M.

In: Epilepsy and Behavior, Vol. 73, 01.08.2017, p. 240-246.

Research output: Contribution to journalArticle

Juengst, SB, Wagner, AK, Ritter, AC, Szaflarski, JP, Walker, WC, Zafonte, RD, Brown, AW, Hammond, F, Pugh, MJ, Shea, T, Krellman, JW, Bushnik, T & Arenth, PM 2017, 'Post-traumatic epilepsy associations with mental health outcomes in the first two years after moderate to severe TBI: A TBI Model Systems analysis', Epilepsy and Behavior, vol. 73, pp. 240-246. https://doi.org/10.1016/j.yebeh.2017.06.001
Juengst, Shannon B. ; Wagner, Amy K. ; Ritter, Anne C. ; Szaflarski, Jerzy P. ; Walker, William C. ; Zafonte, Ross D. ; Brown, Allen W. ; Hammond, Flora ; Pugh, Mary Jo ; Shea, Timothy ; Krellman, Jason W. ; Bushnik, Tamara ; Arenth, Patricia M. / Post-traumatic epilepsy associations with mental health outcomes in the first two years after moderate to severe TBI : A TBI Model Systems analysis. In: Epilepsy and Behavior. 2017 ; Vol. 73. pp. 240-246.
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abstract = "Purpose Research suggests that there are reciprocal relationships between mental health (MH) disorders and epilepsy risk. However, MH relationships to post-traumatic epilepsy (PTE) have not been explored. Thus, the objective of this study was to assess associations between PTE and frequency of depression and/or anxiety in a cohort of individuals with moderate-to-severe TBI who received acute inpatient rehabilitation. Methods Multivariate regression models were developed using a recent (2010–2012) cohort (n = 867 unique participants) from the TBI Model Systems (TBIMS) National Database, a time frame during which self-reported seizures, depression [Patient Health Questionnaire (PHQ)-9], and anxiety [Generalized Anxiety Disorder (GAD-7)] follow-up measures were concurrently collected at year-1 and year-2 after injury. Results PTE did not significantly contribute to depression status in either the year-1 or year-2 cohort, nor did it contribute significantly to anxiety status in the year-1 cohort, after controlling for other known depression and anxiety predictors. However, those with PTE in year-2 had 3.34 times the odds (p = .002) of having clinically significant anxiety, even after accounting for other relevant predictors. In this model, participants who self-identified as Black were also more likely to report clinical symptoms of anxiety than those who identified as White. PTE was the only significant predictor of comorbid depression and anxiety at year-2 (Odds Ratio 2.71; p = 0.049). Conclusions Our data suggest that PTE is associated with MH outcomes 2 years after TBI, findings whose significance may reflect reciprocal, biological, psychological, and/or experiential factors contributing to and resulting from both PTE and MH status post-TBI. Future work should consider temporal and reciprocal relationships between PTE and MH as well as if/how treatment of each condition influences biosusceptibility to the other condition.",
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AU - Wagner, Amy K.

AU - Ritter, Anne C.

AU - Szaflarski, Jerzy P.

AU - Walker, William C.

AU - Zafonte, Ross D.

AU - Brown, Allen W.

AU - Hammond, Flora

AU - Pugh, Mary Jo

AU - Shea, Timothy

AU - Krellman, Jason W.

AU - Bushnik, Tamara

AU - Arenth, Patricia M.

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N2 - Purpose Research suggests that there are reciprocal relationships between mental health (MH) disorders and epilepsy risk. However, MH relationships to post-traumatic epilepsy (PTE) have not been explored. Thus, the objective of this study was to assess associations between PTE and frequency of depression and/or anxiety in a cohort of individuals with moderate-to-severe TBI who received acute inpatient rehabilitation. Methods Multivariate regression models were developed using a recent (2010–2012) cohort (n = 867 unique participants) from the TBI Model Systems (TBIMS) National Database, a time frame during which self-reported seizures, depression [Patient Health Questionnaire (PHQ)-9], and anxiety [Generalized Anxiety Disorder (GAD-7)] follow-up measures were concurrently collected at year-1 and year-2 after injury. Results PTE did not significantly contribute to depression status in either the year-1 or year-2 cohort, nor did it contribute significantly to anxiety status in the year-1 cohort, after controlling for other known depression and anxiety predictors. However, those with PTE in year-2 had 3.34 times the odds (p = .002) of having clinically significant anxiety, even after accounting for other relevant predictors. In this model, participants who self-identified as Black were also more likely to report clinical symptoms of anxiety than those who identified as White. PTE was the only significant predictor of comorbid depression and anxiety at year-2 (Odds Ratio 2.71; p = 0.049). Conclusions Our data suggest that PTE is associated with MH outcomes 2 years after TBI, findings whose significance may reflect reciprocal, biological, psychological, and/or experiential factors contributing to and resulting from both PTE and MH status post-TBI. Future work should consider temporal and reciprocal relationships between PTE and MH as well as if/how treatment of each condition influences biosusceptibility to the other condition.

AB - Purpose Research suggests that there are reciprocal relationships between mental health (MH) disorders and epilepsy risk. However, MH relationships to post-traumatic epilepsy (PTE) have not been explored. Thus, the objective of this study was to assess associations between PTE and frequency of depression and/or anxiety in a cohort of individuals with moderate-to-severe TBI who received acute inpatient rehabilitation. Methods Multivariate regression models were developed using a recent (2010–2012) cohort (n = 867 unique participants) from the TBI Model Systems (TBIMS) National Database, a time frame during which self-reported seizures, depression [Patient Health Questionnaire (PHQ)-9], and anxiety [Generalized Anxiety Disorder (GAD-7)] follow-up measures were concurrently collected at year-1 and year-2 after injury. Results PTE did not significantly contribute to depression status in either the year-1 or year-2 cohort, nor did it contribute significantly to anxiety status in the year-1 cohort, after controlling for other known depression and anxiety predictors. However, those with PTE in year-2 had 3.34 times the odds (p = .002) of having clinically significant anxiety, even after accounting for other relevant predictors. In this model, participants who self-identified as Black were also more likely to report clinical symptoms of anxiety than those who identified as White. PTE was the only significant predictor of comorbid depression and anxiety at year-2 (Odds Ratio 2.71; p = 0.049). Conclusions Our data suggest that PTE is associated with MH outcomes 2 years after TBI, findings whose significance may reflect reciprocal, biological, psychological, and/or experiential factors contributing to and resulting from both PTE and MH status post-TBI. Future work should consider temporal and reciprocal relationships between PTE and MH as well as if/how treatment of each condition influences biosusceptibility to the other condition.

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KW - Traumatic brain injury

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