Personality changes and return to work after severe traumatic brain injury: a prospective study.
OBJECTIVE
To evaluate predictors of non-return to work (nRTW) among social, demographic, clinical, and psychiatric variables after severe traumatic brain injury (TBI) in a cohort of Brazilian patients.


METHODS
Prospective study. Forty-three community-dwelling individuals treated at a Level I trauma center at the time of TBI were evaluated 18 months after trauma. Measures included DSM-IV-TR criteria for personality changes after TBI and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to assess psychiatric diagnosis. Hospitalization variables included Glasgow Coma Scale scores, pupil examination findings, associated limb trauma, Marshall computed tomography classification, and blood glucose levels.


RESULTS
After multiple logistic regression analysis, only the diagnosis of personality changes was found to be independently associated with nRTW, with an adjusted odds ratio of 10.92 (p = 0.02, 95% confidence interval 1.41-84.28).


CONCLUSIONS
In this study, personality changes were an independent predictor of nRTW after severe TBI. Ways to predict risk factors associated with personality changes after severe brain injury could aid in identification of early and effective interventions that might ease the burden associated with this condition.
Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil.
Alexandre P
AP
Diaz
Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil.
Marcelo L
ML
Schwarzbold
Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil.
Maria E
ME
Thais
Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil.
Gisele G
GG
Cavallazzi
Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil.
Roseli
R
Schmoeller
Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil.
Jean C
JC
Nunes
Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil.
Alexandre
A
Hohl
Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil.
Ricardo
R
Guarnieri
Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil.
Marcelo N
MN
Linhares
Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil.
Roger
R
Walz
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D001938:Brazil; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010554:Personality Disorders / Q000209:etiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use; D062707:Return to Work / Q000523:psychology / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D055815:Young Adult
D011619:Psychotropic Drugs