Abstract
Background
Traumatic brain injury (TBI) patients constitute a highly heterogeneous population, with varying risks for New-onset Psychiatric Disorders (NPDs). The objectives of this study were to identify TBI phenotypes and determine how NPDs differ among these phenotypes.
Methods
Hospitalized TBI patients from 2003–2019 were obtained from the provincial trauma registry. Propensity score matched samples were used to estimate the risk of TBI on NPDs. To uncover heterogeneity in TBI, latent class analysis-based clustering was applied. The effect of classes on NPDs was assessed using log binomial regression models.
Results
A total of 3,453 TBI patients were included in the analysis. In a conditional regression involving propensity matched TBI and control patients, TBI was significantly associated with the development of NPD-A (OR: 2.78; 95% CI: 2.49–3.09), as well as NPD-P (OR: 2.36; 95% CI: 2.07–2.70). Eight distinct latent classes were identified which differed in the incidence of NPDs. Four classes displayed a 53% (RR:1.53; 95% CI: 1.31–1.78), 48% (RR:1.48; 95% CI: 1.26–1.74), 28% (RR:1.28; 95% CI: 1.08–1.54), and 20% (RR: 1.20, 95%CI: 1.03–1.39), increased NPD risk.
Conclusion
TBI is a significant predictor of NPDs. There are clinically distinguishable phenotypes with different patterns of NPD risk among TBI patients. Identifying individuals with respect to their phenotype may improve risk stratification of TBI patients and promote early intervention for psychiatric care in this vulnerable population.