Psychiatric disorders following traumatic brain injury: a nationwide population-based cohort study and the effects of rehabilitation therapies

Abstract Objective To investigate the risk of psychiatric disorders following TBI, and to clarify whether the post-TBI rehabilitation was associated with a lower risk of developing psychiatric disorders. Design A register-based, retrospective cohort design Setting Using data from the National Health Insurance Research Database (NHIRD) of Taiwan, we established an exposed cohort with TBI and a nonexposed group without TBI matched by age and year of diagnosis between 2000 and 2015. Participants This study included 231,894 patients with TBI and 695,682 controls. Interventions Rehabilitation therapies in TBI patients. Main Outcome Measures A multivariable Cox proportional hazards regression model was used to compare the risk of developing psychiatric disorders. Results The incidence rate of psychiatric disorders was higher in the TBI group when compared with the control group. Compared with the control group, the risk of psychiatric disorders in the TBI group was twofold (HR=2.056, 95% CI:1.940- 2.172, p Conclusions We found that TBI was associated with a high risk for developing psychiatric disorders, and that the post-TBI rehabilitation significantly reduced the risk of psychiatric disorders in a dose-dependent manner.