title: FACTORS ASSOCIATED WITH POSTTRAUMATIC STRESS DISORDER FOLLOWING MODERATE TO SEVERE TRAUMATIC BRAIN INJURY: A PROSPECTIVE STUDY.
abstract: BACKGROUND
  This study prospectively examined the relationship between preinjury, injury-related, and postinjury factors and posttraumatic stress disorder (PTSD) following moderate to severe traumatic brain injury (TBI).
  
  
  METHODS
  Two hundred and three participants were recruited during inpatient admission following moderate to severe TBI. Participants completed an initial assessment soon after injury and were reassessed at 3, 6, and 12 months, 2, 3, 4, and 5 years postinjury. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-fourth edition was used to diagnose pre- and postinjury PTSD and other psychiatric disorders. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Inventory (QOLI) were used to evaluate functional and psychosocial outcome from 6 months postinjury.
  
  
  RESULTS
  The frequency of PTSD ranged between 0.5 and 9.4% during the 5-year period, increasing throughout the first 12 months and declining thereafter. After controlling for other predictors, shorter posttraumatic amnesia duration (odds ratio = 0.96, 95% CI = 0.92-1.00), other concurrent psychiatric disorder (odds ratio = 14.22, 95% CI = 2.68-75.38), and lower GOSE (odds ratio = 0.38, 95% CI = 0.20-0.72) and QOLI scores (odds ratio = 0.97, 95% CI = 0.95-0.97) were associated with greater odds of having injury-related PTSD.
  
  
  CONCLUSIONS
  The results of this study indicate that while shorter posttraumatic amnesia duration is associated with PTSD, greater TBI severity does not prevent PTSD from evolving. Patients with PTSD experienced high rates of psychiatric comorbidity and poorer functional and quality of life outcomes after TBI.
  
  
  CONCLUSIONS
  There is a need to direct clinical attention to early identification and treatment of PTSD following TBI to improve outcomes.
authors.affiliation: School of Psychological Sciences, Monash University, Melbourne, Australia.|Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia.
authors.forename: Yvette
authors.initials: Y
authors.lastname: Alway
authors.affiliation: School of Psychological Sciences, Monash University, Melbourne, Australia.|Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia.
authors.forename: Adam
authors.initials: A
authors.lastname: McKay
authors.affiliation: School of Psychological Sciences, Monash University, Melbourne, Australia.|Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia.|National Trauma Research Institute, Melbourne, Australia.
authors.forename: Kate Rachel
authors.initials: KR
authors.lastname: Gould
authors.affiliation: Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Johnston
authors.affiliation: School of Psychological Sciences, Monash University, Melbourne, Australia.|Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia.|National Trauma Research Institute, Melbourne, Australia.
authors.forename: Jennie
authors.initials: J
authors.lastname: Ponsford
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology*; D013997:Time Factors; D055815:Young Adult
keywords: anxiety disorder; posttraumatic stress disorder; quality of life; rehabilitation; trauma; traumatic brain injury