title: Anxiety and comorbid depression following traumatic brain injury in a community-based sample of young, middle-aged and older adults.
abstract: Anxiety is common following a traumatic brain injury (TBI), but who is most at risk, and to what extent, is not well understood.
  
  
  
  Longitudinal data from a randomly-selected community sample (Wave 1: 7397, Wave 2: 6621 and Wave 3: 6042) comprising three adult cohorts (young: 20-24 years of age, middle-aged: 40-44, older: 60-64), were analysed. The association between TBI history, anxiety and comorbid depression was assessed, controlling for age, sex, marital/employment status, medical conditions, recent life events, alcohol consumption, social support and physical activity.
  
  
  
  Thirteen percent of the sample had sustained a TBI by Wave 3, 35% of whom had sustained multiple TBIs. Cross-sectional analyses revealed that clinically-significant anxiety was more common in people who had sustained a TBI. Longitudinal analyses demonstrated an increased risk of anxiety post-TBI, even after controlling for potential demographic, health and psychosocial confounds. Anxiety was more common than depression, although 10% of those with a TBI experienced comorbid anxiety/depression.
  
  
  
  TBIs were not medically confirmed and anxiety and depression were only assessed every four years by self-report, rather than clinical interview. Sample attrition resulted in the retention of healthier individuals at each wave.
  
  
  
  TBIs are associated with a lifelong increased risk of experiencing clinically-significant anxiety, highlighting the chronic nature of TBI sequelae. Positive lifestyle changes (e.g., increasing physical activity, reducing alcohol consumption) may decrease the risk of anxiety problems in the early years after a TBI. Comorbid anxiety and depression was common, indicating that both should be monitored and treated.
authors.affiliation: School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: A J
authors.initials: AJ
authors.lastname: Osborn
authors.affiliation: School of Psychology, University of Adelaide, Adelaide, South Australia, Australia. Electronic address: jane.mathias@adelaide.edu.au.
authors.forename: J L
authors.initials: JL
authors.lastname: Mathias
authors.affiliation: School of Psychology, University of Adelaide, Adelaide, South Australia, Australia; School of Psychology, Flinders University, Bedford Park, South Australia, Australia; Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia.
authors.forename: A K
authors.initials: AK
authors.lastname: Fairweather-Schmidt
authors.affiliation: Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia.
authors.forename: K J
authors.initials: KJ
authors.lastname: Anstey
mesh_terms: D000328:Adult; D017677:Age Distribution; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology*; D001315:Australia / Q000453:epidemiology; D000070642:Brain Injuries, Traumatic / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012944:Social Support; D055815:Young Adult
keywords: Anxiety; Community; Depression; Longitudinal; Multivariate; Population; Traumatic brain injury