Research Reports - Racial/ethnic disparities in mental health after traumatic brain injury

Arch Phys Med Rehabil. 2014 Aug 13

Perrin PB(1), Krch D(2), Sutter M(3), Snipes DJ(3), Arango-Lasprilla JC(4),
Kolakowsky-Hayner SA(5), Wright J(5), Lequerica A(2)

OBJECTIVE: To determine whether racial/ethnic disparities occur in depression,
anxiety, and satisfaction with life at 1 and 2 years post-discharge.
DESIGN: A prospective, longitudinal, multicenter study of individuals with
traumatic brain injury (TBI) participating in the National Institute on
Disability and Rehabilitation Research Traumatic Brain Injury Model Systems
project. Medical, demographic, and outcome data were obtained from the Model
Systems database at baseline, as well as 1 and 2 years post-discharge.
SETTING: 16 TBI Model Systems hospitals in the United States.
PARTICIPANTS: Individuals with moderate or severe TBI (N = 1,662) aged 16 or
older consecutively discharged between January 2008 and June 2011 from acute care
and comprehensive inpatient rehabilitation at a Model Systems hospital.
MAIN OUTCOME MEASURES: The Patient Health Questionnaire-9, Generalized Anxiety
Disorder-7, and Satisfaction with Life Scale assessed depression, anxiety, and
satisfaction with life at 1 and 2-year follow-ups.
RESULTS: After controlling for all possible covariates, hierarchal linear models
found that Black individuals had elevated depression across the two time points
relative to Whites. Asian/Pacific Islanders' depression increased over time in
comparison to the decreasing depression in those of Hispanic origin, which was a
greater decrease than White individuals. Black individuals had lower life
satisfaction in comparison to White and Hispanic individuals, but only marginally
greater anxiety over time than White individuals; and similar levels of anxiety
to Asian/Pacific Islander and Hispanic individuals.
CONCLUSIONS: Mental health trajectories of individuals with TBI differed as a
function of race/ethnicity across the first 2 years post-discharge, providing the
first longitudinal evidence of racial/ethnic disparities in mental health after
TBI during this time period. Further research will be required to understand the
complex factors underlying these differences.

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