Lifetime History of Traumatic Brain Injury and Behavioral Health Problems in a Population-Based Sample

Abstract

Objective: To investigate the relationships between indices of lifetime history of traumatic brain injury (TBI) exposure and measures of behavioral health status among Ohioans. Participants: A random sample (n = 6996) of Ohioans contacted to complete the 2014 Ohio Behavioral Risk Factors Surveillance System (BRFSS). Design: A cross-sectional survey. Main measures: The Ohio State University TBI Identification Method adapted for BRFSS module and BRFSS behavioral indicators. Results: After demographic adjustment, lifetime history of TBI was found to be associated with increased odds of binge drinking, heavy drinking, smoking, a depressive disorder, or mental health not being good (≥2 days and ≥14 days in last 30 days). Mixed findings across behavioral indicators were observed in regard to number and severity of injury. Age at first injury showed no remarkable associations with the behavioral health indicators. Conclusions: Ohioans who have sustained at least one TBI with loss of consciousness in their lifetime are at increased risk for poor behavioral health, including alcohol misuse, smoking, and depression. The findings underscore the need for community-based mental health treatment programs to screen for TBI history in their intake evaluations, and to train clinicians on the provisions of accommodations for cognitive and behavioral deficits.

Current health status and history of traumatic brain injury among Ohio adults

“…The findings from this study are consistent with a growing body of research that implicates TBI may facilitate the development of chronic health problems 7 8. There is a well-documented relationship between TBI and depression 23–26. While other psychiatric comorbidities are common following TBI, in many cases these preceded an index injury 27 28.…”

“…In the current study, post hoc review of the frequency with which specific chronic conditions occurred found the unsurprising result that depression was more frequently endorsed. The elevated reports of asthma, COPD and kidney disease may be by-products of other health habits, specifically greater cigarette smoking and alcohol use 26. However, the biological basis of potential direct causal relationships between TBI and the development of chronic health conditions is receiving considerable research attention, which has included inquiry into the contribution of TBI to inflammatory, metabolic and immune system dysfunction 31–33…”

Comparison of Diagnostic Sleep Studies in Hospitalized Neurorehabilitation Patients With Moderate to Severe Traumatic Brain Injury

“…The data reflect diagnostic sensitivity of a portable sleep study during predominantly acute neurologic recovery from moderate to severe TBI. Whether findings would extend to chronic phases of TBI wherein some risk factors for worsening of OSA increase (weight gain, tobacco use, problematic alcohol use) and others decrease (sedating medications), which might result in a different OSA profile, [51][52][53][54][55] is unclear.…”

Comparative Effectiveness of Sleep Apnea Screening Instruments During Inpatient Rehabilitation Following Moderate to Severe TBI

“…It is unclear if findings would extend to chronic phases of TBI wherein some risk factors for worsening of OSA increase (weight gain, tobacco use, problematic alcohol use) and others decrease (sedating medications), potentiating a different risk profile. [41][42][43][44][45] Future analyses planned with these data include subgroup analyses for age and military status.…”