Traumatic brain injury and mental health among two American Indian populations.
OBJECTIVE
Describes prevalence of traumatic brain injury (TBI) and associated neuropsychiatric problems among two American Indian (AI) communities.


METHODS
Analysis of cross-sectional epidemiological data.


METHODS
A Southwest (SW) and 2 Northern Plains (NP) AI reservations.


METHODS
AI tribal members (N=2687; 394 with history of TBI and 2293 noninjured comparisons) aged 15 to 54.


METHODS
Mood or anxiety disorders present more than 1 year after injury.


RESULTS
Prevalences were high (>20% in males; >10% in females) in these populations. Associations between TBI and disorders meeting Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition criteria were strong in the SW community (adjusted odds ratio [OR]=2.4; 95% confidence interval [CI]=1.5-3.8), less so in the NP community (adjusted OR=1.4; 95% CI=0.9-2.2).


CONCLUSIONS
TBI is prevalent among AIs and is associated with increased OR of neuropsychiatric difficulties. This association may vary between tribes, though no interaction effect was found. AIs with TBI may require more thorough psychiatric screening to promote healthier outcomes.
Nelson
Lonnie A
LA
Department of Psychiatry, School of Medicine, University of Washington, Seattle, WA 98101, USA. lanelsonphd@gmail.com
Rhoades
Dorothy A
DA
Noonan
Carolyn
C
Manson
Spero M
SM
D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000208:ethnology*; D001930:Brain Injuries / Q000208:ethnology* / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000208:ethnology*; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology