Measuring mood following traumatic brain injury (TBI) using hospital anxiety and depression scale (HADS)
thesisposted on 2023-05-27, 14:25 authored by Holm, KCC
There is little published research following the emotional recovery of patients with Traumatic Brain Injury (TBI). The present research aimed to investigate in a series of four studies, the relationship between the Hospital Anxiety and Depression Scale (HADS) and a number of variables (demographic, clinical and psychological/physiological) over 2 years following TBI. This large-scale Tasmanian-based population study consisted of 1044 TBI patients (65% males, mean age = 36 yrs) identified from the Neuro Trauma Register database, who completed the HADS and a number of scales and interview questions at the initial follow-up (< 15 days post-injury), 1 month, 3 months, 6 months, 12 months and 24 months post-injury. The data was analysed in a series of longitudinal analyses (repeated measures ANOVAS), cross-sectional analyses (between subjects t-tests and ANOVAS), and multiple regression analyses. The findings indicated greater levels of pain and fatigue, lower levels of subjective quality of life (SQOL), and increased severity of post-concussion symptoms were associated with higher levels of anxiety, depression, and psychomotor symptoms across the 2-year postinjury period‚ÄövÑvÆwith large effect sizes noted. A number of regression models predicted participants' emotional recovery at the later assessments, explaining up to 64% of variance on the HADS. Variables consistently featuring in the models included the HADS Anxiety, Depression, and Psychomotor factors, and variables measuring levels of post-concussion symptoms, SQOL, est. pre-morbid intelligence, and pain. The findings of the present research highlight the importance for early screening of TBI patients' emotional outcome to enable early intervention and suggest the Skilbeck et al. (2011) HADS 3-factor model can be effectively used to identify patients at risk of developing disturbances in anxiety, depression, and psychomotor domains across two years post-TBI. Service implications and directions for future research are discussed.
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