Affiliations: [a] University of California, San Diego, La Jolla, CA, USA | [b] Rady Children's Hospital, San Diego, CA, USA | [c] Baylor College of Medicine, Houston, TX, USA | [d] Brigham Young University, Provo, UT, USA | [e] The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada | [f] University of Texas Health Science Center, Houston, TX, USA | [g] University of Texas, Dallas, TX, USA | [h] University of California, San Francisco, CA, USA
Correspondence:
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Corresponding author: Jeffrey E. Max, Rady Children's Hospital, 3020 Children's Way, MC 5018, San Diego, CA 92123, USA. Tel.: +1 858 966 5832 ext. 5743; Fax: +1 858 966 4056; E-mail:jmax@ucsd.edu
Abstract: 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.
Keywords: Anxiety, traumatic brain injury, child and adolescent psychiatric disorders
