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Article

The Association of Post-Concussion and Post-Traumatic Stress Disorder Symptoms with Health-Related Quality of Life, Health Care Use and Return-to-Work after Mild Traumatic Brain Injury

1
Department of Public Health, Erasmus MC, 3000 CA Rotterdam, The Netherlands
2
Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG), Georg-August-University, 37073 Göttingen, Germany
3
Department of Psychology, Antwerp University Hospital, University of Antwerp, 2650 Edegem, Belgium
*
Author to whom correspondence should be addressed.
The list of CENTER-TBI Participants and Investigators is provided in the Supplementary Materials.
Academic Editor: Morgan Broggi
J. Clin. Med. 2021, 10(11), 2473; https://doi.org/10.3390/jcm10112473
Received: 30 April 2021 / Revised: 28 May 2021 / Accepted: 1 June 2021 / Published: 2 June 2021
(This article belongs to the Special Issue Traumatic Brain Injury: Recent Developments and Emerging Trends)
Patients with mild traumatic brain injury (mTBI) are at risk for post-concussion (PC) symptoms and post-traumatic stress disorder (PTSD). The co-occurrence of PC and PTSD symptoms after mTBI in relation to health-related quality of life (HRQoL), health care utilization, and return to work has not yet been investigated. PC and PTSD symptoms were measured six months post-TBI by respectively the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5). Of the 1566 individuals after mTBI who met the inclusion criteria, 26.1% experienced PC symptoms (RPQ ≥16). Additionally, 9.8% experienced PTSD symptoms (PCL-5 ≥ 33), of which the vast majority (81%) also reported experiencing PC symptoms. Differences between patients with no/mild symptoms, with only PC, only PTSD, and both PC and PTSD symptoms in HRQoL, return to work, and rehabilitation were analyzed using logistic and linear regression analyses. Patients with PC and/or PTSD symptoms reported lower HRQoL, higher rates of rehabilitation, and lower return to work rates compared to patients with no/mild symptoms. Patients with both PC and PTSD symptoms reported significantly lower HRQoL (B = −2.73, CI = −4.65; −0.83, p < 0.001) compared to those with only PC symptoms, while there were no significant differences in their ongoing rehabilitation care (OR = 1.39, CI = 0.77–2.49, p = 0.272) and return to work rates (OR = 0.49, CI = 0.15–1.63, p = 0.246) at six months. These results underline the importance of the diagnosis and appropriate treatment of patients with mTBI, experiencing PC and/or PTSD symptoms. View Full-Text
Keywords: traumatic brain injury (TBI); post-concussion symptoms; Rivermead Post-Concussion Symptoms Questionnaire (RPQ); post-traumatic stress disorder; health-related quality of life; TBI outcome traumatic brain injury (TBI); post-concussion symptoms; Rivermead Post-Concussion Symptoms Questionnaire (RPQ); post-traumatic stress disorder; health-related quality of life; TBI outcome
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MDPI and ACS Style

van der Vlegel, M.; Polinder, S.; Mikolic, A.; Kaplan, R.; von Steinbuechel, N.; Plass, A.M.; Zeldovich, M.; van Praag, D.; Bockhop, F.; Cunitz, K.; Mueller, I.; Haagsma, J.A.; The CENTER-TBI Participants and Investigators. The Association of Post-Concussion and Post-Traumatic Stress Disorder Symptoms with Health-Related Quality of Life, Health Care Use and Return-to-Work after Mild Traumatic Brain Injury. J. Clin. Med. 2021, 10, 2473. https://doi.org/10.3390/jcm10112473

AMA Style

van der Vlegel M, Polinder S, Mikolic A, Kaplan R, von Steinbuechel N, Plass AM, Zeldovich M, van Praag D, Bockhop F, Cunitz K, Mueller I, Haagsma JA, The CENTER-TBI Participants and Investigators. The Association of Post-Concussion and Post-Traumatic Stress Disorder Symptoms with Health-Related Quality of Life, Health Care Use and Return-to-Work after Mild Traumatic Brain Injury. Journal of Clinical Medicine. 2021; 10(11):2473. https://doi.org/10.3390/jcm10112473

Chicago/Turabian Style

van der Vlegel, Marjolein, Suzanne Polinder, Ana Mikolic, Rana Kaplan, Nicole von Steinbuechel, Anne M. Plass, Marina Zeldovich, Dominique van Praag, Fabian Bockhop, Katrin Cunitz, Isabelle Mueller, Juanita A. Haagsma, and The CENTER-TBI Participants and Investigators. 2021. "The Association of Post-Concussion and Post-Traumatic Stress Disorder Symptoms with Health-Related Quality of Life, Health Care Use and Return-to-Work after Mild Traumatic Brain Injury" Journal of Clinical Medicine 10, no. 11: 2473. https://doi.org/10.3390/jcm10112473

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