Depression, anxiety and employment status after traumatic brain injury

Abstract

Purpose

In addition to physical, behavioural and cognitive impairment, emotional difficulties such as anxiety and depression are also common after traumatic brain injury (TBI) and can contribute to chronic disability. Understanding more about the relationship between emotional problems and social factors such as employment status after TBI can potentially help to inform rehabilitation practice to improve long‐term outcomes. This study attempts to determine if depression and/or anxiety after TBI are associated with being unemployed.

Design/methodology/approach

This quantitative study considered the associations between depression, anxiety and employment status in people with TBI. The participants were 62 adults with a history of TBI, on average 99 months post‐injury, and attending community‐based rehabilitation. Data regarding anxiety and depression as measured by the HADS as well as employment status were collected and analyzed for potential associations between these variables.

Findings

A statistically significant association between the presence of depression and not being in employment was revealed by this study. The same association, however, was not found for anxiety and employment status. The relationship between depression and employment may be complex and should also be considered within for example the societal context, including actual availability of opportunities for employment, legislation and statutory initiatives to facilitate return to work initiatives. The employment of disabled persons, including as a result of TBI, should be viewed within the wider context of societal discrimination against disabled people.

Research limitations/implications

There are several limitations to be considered when interpreting the findings from this study, including modest sample size, a broad range in time since injury, the wide age range of the participants, as well as the use of only questionnaires to confirm the presence or absence of depression and anxiety symptoms after TBI.

Practical implications

Practitioners should be aware of the potential adverse effect of depression and anxiety on outcome after TBI. Where limited opportunity exists for successful employment outcome after TBI, practitioners should work towards preventing repeated failure in persons with TBI trying to get back to work. Specialist case management may have a valuable role to play in this area.

Originality/value

This study confirms an association between unemployment and depression in people with TBI.

Citation

Coetzer, R., Carroll, E. and Ruddle, J.A. (2011), "Depression, anxiety and employment status after traumatic brain injury", Social Care and Neurodisability, Vol. 2 No. 4, pp. 200-207. https://doi.org/10.1108/20420911111188452