Anxiety and comorbid depression following traumatic brain injury in a community-based sample of young, middle-aged and older adults

Amanda Osborn, Jane Mathias, Alicia Fairweather-Schmidt, K Anstey

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    24 Citations (Scopus)


    Background Anxiety is common following a traumatic brain injury (TBI), but who is most at risk, and to what extent, is not well understood. Methods Longitudinal data from a randomly-selected community sample (Wave 1: 7397, Wave 2: 6621 and Wave 3: 6042) comprising three adult cohorts (young: 20–24 years of age, middle-aged: 40–44, older: 60–64), were analysed. The association between TBI history, anxiety and comorbid depression was assessed, controlling for age, sex, marital/employment status, medical conditions, recent life events, alcohol consumption, social support and physical activity. Results Thirteen percent of the sample had sustained a TBI by Wave 3, 35% of whom had sustained multiple TBIs. Cross-sectional analyses revealed that clinically-significant anxiety was more common in people who had sustained a TBI. Longitudinal analyses demonstrated an increased risk of anxiety post-TBI, even after controlling for potential demographic, health and psychosocial confounds. Anxiety was more common than depression, although 10% of those with a TBI experienced comorbid anxiety/depression. Limitations TBIs were not medically confirmed and anxiety and depression were only assessed every four years by self-report, rather than clinical interview. Sample attrition resulted in the retention of healthier individuals at each wave. Conclusions TBIs are associated with a lifelong increased risk of experiencing clinically-significant anxiety, highlighting the chronic nature of TBI sequelae. Positive lifestyle changes (e.g., increasing physical activity, reducing alcohol consumption) may decrease the risk of anxiety problems in the early years after a TBI. Comorbid anxiety and depression was common, indicating that both should be monitored and treated.

    Original languageEnglish
    Pages (from-to)214-221
    Number of pages8
    JournalJournal of Affective Disorders
    Early online date2016
    Publication statusPublished - 15 Apr 2017


    • Anxiety
    • Community
    • Depression
    • Longitudinal
    • Multivariate
    • Population
    • Traumatic brain injury


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