Mild traumatic brain injury and fatigue: a prospective longitudinal study.
OBJECTIVE
To examine fatigue prevalence, severity, predictors and co-variates over 6 months post-mild traumatic brain injury (MTBI).


METHODS
Longitudinal prospective study including 263 adults with MTBI.


METHODS
Participants completed the Fatigue Severity Scale (FSS), Rivermead Post-concussion Symptoms Questionnaire (RPSQ), Hospital Anxiety and Depression Scale (HADS) and the Short Form 36 Health Survey-Version 2 (SF-36v2). Complete data were available for 159 participants. Key measures; prevalence--RPSQ Item 6: severity--FSS. The effect of time on fatigue prevalence and severity was examined using ANOVA. Multiple regression analysis identified statistically significant covariates.


RESULTS
Post-MTBI fatigue prevalence was 68%, 38% and 34% at 1 week, 3 and 6 months, respectively. There was a strong effect for time over the first 3 months and moderate-to-high correlations between fatigue prevalence and severity. Early fatigue strongly predicted later fatigue; depression, but not anxiety was a predictor. Fatigue was seen as laziness by family or friends in 30% of cases.


CONCLUSIONS
Post-MTBI fatigue is a persistent post-concussion symptom, exacerbated by depression but not anxiety. It diminishes in the first 3 months and then becomes relatively stable, suggesting the optimum intervention placement is at 3 months or more post-MTBI.
Department of Psychology, Massey University, Palmerston North, New Zealand. j.m.norrie@massey.ac.
Joan
J
Norrie
Marcus
M
Heitger
Janet
J
Leathem
Tim
T
Anderson
Richard
R
Jones
Ross
R
Flett
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001924:Brain Concussion / Q000150:complications / Q000523:psychology*; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D005190:Family / Q000523:psychology*; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult