title: Clinically significant changes in the emotional condition of relatives of patients with severe traumatic brain injury during sub-acute rehabilitation.
abstract: OBJECTIVE
  To investigate clinically significant change in the emotional condition of relatives of patients with severe traumatic brain injury during sub-acute rehabilitation.
  
  
  METHODS
  Participants were 62 pairs of relatives and patients. Relatives completed the anxiety and depression scales from the Symptom Checklist-90-R (SCL-90-R) when the patients were admitted to sub-acute rehabilitation and at discharge. Improvement in emotional condition was investigated using the following criteria: (i) statistically reliable improvement; and (ii) clinically significant change (CSC).
  
  
  RESULTS
  At admission, 53.2% and 58.1% of relatives had scores above cut-off values on the anxiety and depression scales, respectively. On the anxiety scale 69.7% of these experienced a reliable improvement according to the Reliable Change Index (RCI) and 45.5% also obtained CSC, as their end-point was below the cut-off value. On the depression scale the corresponding figures were 44.4% and 41.7%, respectively. When comparing relatives with and without CSC, we found that CSC in symptoms of anxiety was associated with significantly better functional improvement during rehabilitation and a shorter period of post-traumatic amnesia in the patients.
  
  
  CONCLUSIONS
  Of the relatives who reported scores above cut-off values on the anxiety and depression scales at patient's admission, approximately 40% experienced CSC in anxiety and depression during the patient's rehabilitation. Relatives of patients experiencing improvement during inpatient rehabilitation are more likely to experience CSC in anxiety.
authors.affiliation: Department of Neurorehabilitation, Traumatic Brain Injury Unit, Copenhagen University Hospital, Glostrup, Denmark. anne.norup@regionh.dk
authors.forename: Anne
authors.initials: A
authors.lastname: Norup
authors.forename: Karin Spangsberg
authors.initials: KS
authors.lastname: Kristensen
authors.forename: Ingrid
authors.initials: I
authors.lastname: Poulsen
authors.forename: Christina Löfvquist
authors.initials: CL
authors.lastname: Nielsen
authors.forename: Erik Lykke
authors.initials: EL
authors.lastname: Mortensen
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation*; D003863:Depression; D004644:Emotions; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological; D019467:Subacute Care