The Effect of Preinjury Psychiatric Difficulties on Caregiving Needs and Postinjury Emotional Distress in Care Partners of Persons With Traumatic Brain Injury.

OBJECTIVE

To examine differences in postinjury needs in traumatic brain injury (TBI) care partners with and without a preinjury psychiatric history (positive preinjury psychiatric history [PH+] vs negative preinjury psychiatric history [PH-]).

DESIGN

A multisite, prospective, observational cohort study.

SETTING

Community.

PARTICIPANTS

Two hundred fifty-eight care partners (N=258) for persons with TBI meeting the following criteria: ≥18 years old; nonpaid caregiver; TBI care recipient criteria: ≥16 years old at time of injury, TBI requiring inpatient rehabilitation; acute hospitalization/admission at Traumatic Brain Injury Model System-approved inpatient rehabilitation site.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Family Needs Questionnaire-Revised assessed percentage of emotional, instrumental, professional, and community support needs met at 6 months after injury.

SECONDARY OUTCOME MEASURES: Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 assessed care partner depression and anxiety at 6, 12, and 24 months after injury.

RESULTS

At 6 months after injury, care partners reported more met needs for community support relative to instrumental support needs (estimates, 7.30; 95% confidence interval [CI], 3.91-10.69; P<.001). PH+ care partners did not differ from PH- care partners in the percentage of met needs across any need category. Number of psychiatric diagnoses (0 vs 1 vs 2 vs 3+) was not associated with differences in met needs. PH+ care partners endorsed more depression and anxiety symptoms than PH- care partners from 6 to 24 months after injury (depression: estimates, 3.78; 95% CI, 2.55-5.00; P<.001; anxiety: estimates, 2.91; 95% CI, 1.58-4.24; P<.001).

CONCLUSIONS

While PH+ TBI care partners do not appear to have differing needs compared to PH- care partners at 6 months after injury, they do experience persistent emotional distress. Evaluating care partners' psychiatric history is warranted to identify caregivers vulnerable to developing post-TBI emotional distress.