title: The psychosocial difficulties in brain disorders that explain short term changes in health outcomes.
abstract: BACKGROUND
  This study identifies a set of psychosocial difficulties that are associated with short term changes in health outcomes across a heterogeneous set of brain disorders, neurological and psychiatric.
  
  
  METHODS
  Longitudinal observational study over approximately 12 weeks with three time points of assessment and 741 patients with bipolar disorders, depression, migraine, multiple sclerosis, parkinson's disease, stroke and traumatic brain injury. The data on disability was collected with the checklist of the International Classification of Functioning, Disability and Health. The selected health outcomes were the Short Form 36 and the World Health Organization Disability Assessment Schedule. Multilevel models for change were applied controlling for age, gender and disease severity.
  
  
  RESULTS
  The psychosocial difficulties that explain the variability and change over time of the selected health outcomes were energy and drive, sleep, and emotional functions, and a broad range of activities and participation domains, such as solving problems, conversation, areas of mobility and self-care, relationships, community life and recreation and leisure.
  
  
  CONCLUSIONS
  Our findings are of interest to researchers and clinicians for interventions and health systems planning as they show that in addition to difficulties that are diagnostic criteria of these disorders, there are other difficulties that explain small changes in health outcomes over short periods of time.
authors.forename: Alarcos
authors.initials: A
authors.lastname: Cieza
authors.forename: Cristina
authors.initials: C
authors.lastname: Bostan
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Ayuso-Mateos
authors.forename: Cornelia
authors.initials: C
authors.lastname: Oberhauser
authors.forename: Jerome
authors.initials: J
authors.lastname: Bickenbach
authors.forename: Alberto
authors.initials: A
authors.lastname: Raggi
authors.forename: Matilde
authors.initials: M
authors.lastname: Leonardi
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
authors.forename: Somnath
authors.initials: S
authors.lastname: Chatterji
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000523:psychology; D001927:Brain Diseases / Q000523:psychology*; D001930:Brain Injuries / Q000523:psychology; D003866:Depressive Disorder / Q000523:psychology; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology; D004644:Emotions; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000523:psychology; D019964:Mood Disorders / Q000523:psychology*; D009103:Multiple Sclerosis / Q000523:psychology; D010300:Parkinson Disease / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology; D020521:Stroke / Q000523:psychology