Apathy Level, Disinhibition, and Psychiatric Conditions Are Related to the Employment Status of People With Traumatic Brain Injury

Abstract

Abstract Importance: An understanding of the potential prognostic factors as they relate to the employment status of people with traumatic brain injury (TBI) is necessary so that occupational therapy practitioners can provide the most effective treatment. Objective: To examine the impact of apathy, disinhibition, and psychiatric conditions on employment status after TBI. Design: An observational study conducted from March 2015 to March 2020. Setting: Cognitive dysfunction clinics associated with two general hospitals in Japan. Participants: Japanese people of working age (N = 110, ages 18–65 yr) with TBI. Outcomes and Measures: As an outcome indicator, each participant’s employment status was rated on a 3-point scale (i.e., 3 = regular employment, 2 = welfare employment [employed as a person with disabilities or undergoing vocational training in the Japanese welfare employment system, for which a worker is paid under either system], 1 = unemployment). Psychiatric, neuropsychological, and physical assessments were measured as explanatory variables. The impact of various factors on employment status was investigated using linear discriminant regression analysis. Results: The level of apathy, disinhibition, and incidence of psychiatric conditions after TBI, as well as age and years postinjury, were related to employment status. Conclusion and Relevance: Although this is a cross-sectional study, interventions for apathy and disinhibition, as well as management of psychiatric conditions, are recommended to help improve employment status among people with TBI. What This Article Adds: The employment status of people with TBI is related more to apathy, disinhibition, and psychiatric conditions than to intelligence, memory function, or executive function.