Objective: To examine the relationship between medical comorbidities and psychological health outcomes at 2 and 5 years following traumatic brain injury (TBI). Method: Veterans Affairs (VA) TBI Model System participants who completed a 2-year (n = 225) and/or 5-year (n = 283) follow-up with a comorbidities interview were included in the current study. Psychological health outcomes were assessed using the Patient Global Impression of Change (PGIC), Patient Health Questionnaire-9 (PHQ-9), and Satisfaction with Life Scale (SWLS). While controlling for known predictors of outcome, the relationship of overall comorbidity burden to psychological outcomes was examined cross-sectionally using generalized linear regression at 2 and 5 years post-TBI. Lasso regularization was used to examine relationships of specific comorbid conditions to outcome. Results: Greater comorbidity burden was significantly associated with lower satisfaction with life at 2 and 5 years post-TBI and was associated with greater depressive symptomatology at 5 years post-TBI. Chronic pain was associated with lower satisfaction with life and greater depressive symptoms at both 2- and 5-year follow-up. Sleep apnea was associated with lower satisfaction with life and greater depressive symptoms at 5-year follow-up. Rheumatoid arthritis was associated with lower satisfaction with life and lower levels of perceived improvement in health and well-being at the 5-year follow-up. Implications: Results suggest that medical comorbidities may have a cumulative impact on adverse psychological health outcomes in chronic stages of TBI. This study further highlights the complexity of patients with TBI and the importance of identifying medical comorbidities as they provide potential targets for intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

---

外伤性脑损伤 (TBI) 后 2 年和 5 年医学合并症与心理健康的关系。

目的：检查外伤性脑损伤（TBI）后 2 年和 5 年的医学合并症与心理健康结果之间的关系。方法：退伍军人事务部 (VA) TBI 模型系统参与者完成了 2 年 (n = 225) 和/或 5 年 (n = 283) 随访并进行了合并症访谈，这些参与者包括在当前研究中。使用患者总体变化印象 (PGIC)、患者健康问卷 9 (PHQ-9) 和生活满意度量表 (SWLS) 评估心理健康结果。在控制已知的结果预测因素的同时，在 TBI 后 2 年和 5 年使用广义线性回归横断面检查总体合并症负担与心理结果的关系。套索正则化用于检查特定合并症与结果的关系。结果：更大的合并症负担与 TBI 后 2 年和 5 年较低的生活满意度显着相关，并且与 TBI 后 5 年的抑郁症状更严重相关。在 2 年和 5 年的随访中，慢性疼痛与生活满意度降低和抑郁症状加重有关。在 5 年的随访中，睡眠呼吸暂停与较低的生活满意度和较严重的抑郁症状相关。在 5 年的随访中，类风湿性关节炎与较低的生活满意度和较低的健康和幸福感改善水平相关。影响：结果表明，合并症可能对 TBI 慢性阶段的不良心理健康结果产生累积影响。这项研究进一步强调了 TBI 患者的复杂性以及识别医学合并症的重要性，因为它们为干预提供了潜在的目标。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。