Depression, Anxiety, and Suicidality in Individuals With Chronic Traumatic Brain Injury Before and During the COVID-19 Pandemic: A National Institute on Disability, Independent Living, and Rehabilitation Research Traumatic Brain Injury Model Systems Study.
Sheryl Katta-Charles, Leah M Adams, Nancy D Chiaravalloti and 6 others
PMID 36632965WHAT IT FOUND
Depression, anxiety, and suicidal thoughts in people with chronic traumatic brain injury did not increase during the COVID-19 pandemic compared with before it.
Symptoms remained stable, though disability and substance use consistently predicted higher distress.
Key findings
01There were no meaningful differences in depression severity, moderate-severe depression prevalence, suicidal ideation, or anxiety severity between the pre-pandemic and pandemic periods.
02After controlling for other factors, the pandemic period itself was not associated with any of the mental health outcomes assessed.
03Greater disability was the strongest predictor of higher depression and anxiety symptoms, showing a medium-sized association.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The analysis was restricted to individuals able to self-report their symptoms. About 1700 participants were excluded because data came from proxy sources, meaning the findings may not reflect the experience of those with more severe disability who cannot complete surveys themselves. Data from March 2020 were excluded to avoid ambiguity in timing, which might miss the immediate acute stress of the pandemic's onset. The study lacked a general population control group, so it cannot determine if the stability of symptoms in TBI patients was different from trends in the general public. The sample was drawn from specialized inpatient rehabilitation centers, so results may not generalize to individuals with TBI who did not receive such care, particularly those from minoritized backgrounds or with limited resources.
Declared interests
The paper is supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). No other conflicts of interest are reported.
The easy way to misread this
Do not conclude that the pandemic had no effect on mental health for all people with TBI. The study excluded those too disabled to self-report, and it only measured symptoms collected at specific follow-up points, potentially missing acute distress or changes in those who could not participate.