Long-term psychosocial outcome following mild traumatic brain injury and minor stroke: a direct longitudinal comparison

Abstract

Background and purpose Research suggests comparable long-term psychosocial outcomes following mild traumatic brain injury (mTBI) and minor stroke, but no direct comparison has been made. This study aimed to directly compare psychosocial outcome over time in persons with mTBI and minor stroke. Methods In this multicenter, prospective longitudinal cohort study, community-dwelling persons with mTBI (n = 182) and minor stroke (n = 48) were assessed at 6 weeks, 3, 6 and 12 months post-injury. Outcome measures included anxiety and depression symptoms (Hospital Anxiety and Depression Scale—HADS), cognitive problems in daily life (Checklist for Cognitive and Emotional Consequences of Stroke—CLCE-24) and quality of life (EuroQol-5D-5L—EQ-5D-5L). Multilevel growth curve modeling, controlled for demographic variables, was used to determine outcomes over time between groups. Proportions of persons reporting persistent psychosocial symptoms at 6 months post-injury were compared using Pearson’s Chi-squared tests. Results Improvements in outcomes were observed in the first 6 months and effects stabilized to 12 months post-injury in both groups. Minor stroke cases reported significantly higher levels of HADS anxiety and a significantly reduced increase in EQ-5D-5L utility scores than mTBI cases, but differences were small in absolute numbers. No significant differences were observed between groups regarding HADS depression and CLCE-24 cognition scores. Proportions of persons reporting persistent psychosocial symptoms were equal between groups. Conclusions Psychosocial outcome is largely comparable following mTBI and minor stroke. Specific attention should be paid to anxiety symptoms and cognitive problems in daily life for which uniform aftercare seems appropriate.

Trajectories of fatigue and related outcomes following mild acquired brain injury: a multivariate latent class growth analysis

“…A further strength is the novel inclusion of both mild stroke and mTBI patients in the model. Both groups often use the same resources for treatment and while past research has shown that mood and cognitive outcomes are comparable between groups ( 8 ), the current study provides further support for this finding with regard to fatigue.…”

“…Data used in the present study were collected as part of a larger dataset investigating emotional and cognitive recovery following ABI ( 8 ). This study was a multicentre, prospective, longitudinal observational cohort study following participants with mild to moderate TBI, stroke or other forms of ABI over the course of 12 months.…”

Acceptance and commitment therapy for individuals with depressive and anxiety symptoms following acquired brain injury: A non-concurrent multiple baseline design across four cases

“…However, it seems that levels and aetiology of depression generally do not differ between stroke or TBI patients (Blicher & Nielsen, 2008 ), nor does their coping style (Herrmann et al, 2000 ). Levels of anxiety can be higher for patients with a stroke, since they can experience fear of stroke recurrence (Chun et al, 2018 ; Verberne et al, 2021 ). Further research should focus on possible differences in the effectiveness of ACT for patients with different types of ABI.…”

Anxiety and depression in people with acquired brain injury

“…Kangas and McDonald (74) had published an article describing that ACT could be an interesting treatment option for people with ABI-related depression symptoms and Soo et al (75) did this for ABI-related anxiety symptoms. Furthermore, Graham et al (76) performed a case study in which a man with poststroke depressive symptoms and medically unexplained symptoms benefited from an ACT intervention. Besides, Whiting (77) described the results of a pilot RCT in which they compared ACT (n = 10) to befriending therapy (n = 9) for people with severe TBI and psychological distress.…”

“…However, it seems that levels and aetiology of depression generally do not differ between stroke or TBI patients (73), nor does their coping style (74). Levels of anxiety can be higher for patients with a stroke, since they can experience fear of stroke recurrence (75,76). Further research should focus on possible differences in the effectiveness of ACT for patients with different types of ABI.…”