Neuropsychiatric symptoms are common, comorbid, and often disabling for patients with traumatic brain injury (TBI). Identifying transdiagnostic symptom dimensions post-TBI may help overcome limitations of traditional psychiatric diagnoses and advance treatment development. We characterized the dimensional structure of neuropsychiatric symptoms at 2-weeks postinjury in n = 1,732 TBI patients and n = 238 orthopedic-injured trauma controls (OTC) from the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. Symptoms were reported on the Brief Symptom Inventory-18, Patient Health Questionnaire-9 Depression checklist, PTSD Checklist for DSM-5, PROMIS Pain Intensity scale, and Insomnia Severity Index. We established a novel factor model of neuropsychiatric symptoms and evaluated how 3 TBI severity strata and OTC patients differed in symptom severity. The final factor model had 6 first-order factors subsumed by 2 second-order factors: Internalizing (encompassing Depression, Anxiety, and Fear) and Somatic symptoms (Sleep, Physical, Pain). Somatic symptoms fit better as a correlated factor of (vs. a lower-order factor within) Internalizing. All symptom dimensions except for Pain were more severe in 1 or more TBI subgroups, as compared to the OTC group. Milder brain injury was generally associated with more severe symptoms, whereas more general injury severity (higher level of care, e.g., emergency department, intensive care unit) was associated with more pain. The findings indicate a broad factor resembling the internalizing factor of general psychopathology in traumatically injured patients, alongside a distinct somatic symptom factor. Brain injury, especially milder brain injury, may exacerbate liabilities toward these symptoms. These neuropsychiatric dimensions may help advance more precision medicine research for TBI. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

---

精神病理学的跨诊断维度与创伤性脑损伤 (TBI) 之间的关系：TRACK-TBI 研究。

对于创伤性脑损伤 (TBI) 患者，神经精神症状是常见的、共病的，并且常常使患者致残。识别 TBI 后的跨诊断症状维度可能有助于克服传统精神病学诊断的局限性并推进治疗发展。我们从 TBI 转化研究和临床知识 (TRACK-TBI) 研究中对 n = 1,732 名 TBI 患者和 n = 238 名骨科受伤的创伤对照 (OTC) 的损伤后 2 周的神经精神症状的维度结构进行了描述。在简要症状清单 18、患者健康问卷 9 抑郁检查表、DSM-5 的 PTSD 检查表、PROMIS 疼痛强度量表和失眠严重程度指数中报告了症状。我们建立了一个新的神经精神症状因素模型，并评估了 3 名 TBI 严重程度分层和 OTC 患者在症状严重程度方面的差异。最终的因子模型有 6 个一级因子，包含 2 个二级因子：内化（包括抑郁、焦虑和恐惧）和躯体症状（睡眠、身体、疼痛）。躯体症状更适合作为内化的相关因素（与内化的低阶因素相比）。与 OTC 组相比，除疼痛外的所有症状维度在 1 个或多个 TBI 亚组中更为严重。较轻的脑损伤通常与更严重的症状相关，而更一般的损伤严重程度（更高级别的护理，例如急诊室、重症监护室）与更多的疼痛相关。研究结果表明，一个广泛的因素类似于外伤患者的一般精神病理学的内化因素，以及一个明显的躯体症状因素。脑损伤，尤其是轻度脑损伤，可能会加剧对这些症状的影响。这些神经精神维度可能有助于推进更多针对 TBI 的精准医学研究。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。