Research Reports - Anxiety disorders in children and adolescents in the second six months after traumatic brain injury

J Pediatr Rehabil Med. 2015 Dec 1;8(4):345-55. doi: 10.3233/PRM-150352.

Max JE(1,)(2), Lopez A(1), Wilde EA(3), Bigler ED(4), Schachar RJ(5), Saunders
A(6), Ewing-Cobbs L(6), Chapman SB(7), Yang TT(8), Levin HS(3).

The objective of this prospective longitudinal study was to assess the nature,
rate, predictive variables, and neuroimaging characteristics of novel (new-onset)
anxiety disorders (compared with no novel anxiety disorders) 6-12 months after
pediatric traumatic brain injury (TBI). Psychiatric and psychosocial interviews
were administered to children who sustained mild to severe TBI at baseline (soon
after injury) and at the 12-month follow-up post-injury (n= 125). The psychiatric
outcome of children 12-months post-injury revealed that novel anxiety disorders
present in the second six months after TBI were heterogeneous and occurred in 13
(10.4%) participants. Novel anxiety disorder was significantly associated with
concurrent novel depressive disorder and with novel personality change due to
TBI. Novel anxiety disorder was marginally associated with younger age at injury
and with pre-injury anxiety disorder in univariate analyses. Age at injury,
pre-injury anxiety disorder, and personality change due to TBI were each
significantly and independently related to novel anxiety disorder in a logistic
regression analysis. There were no significant neuroimaging group differences.
These findings suggest that the emergence of novel anxiety disorder after TBI
might be related to a broader problem of affective dysregulation especially in
younger children and those with a vulnerability even to pre-injury anxiety
disorder. 

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