The pattern of psychological distress in the first 2 years after a severe traumatic brain injury

0646 The pattern of psychological distress in the first two years after a severe traumatic brain injury Diane Randall1, Diane Whiting 2, Matthew Thomas1 1School of Psychology, Charles Sturt University, Bathurst, NSW, Australia, 2Liverpool Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, NSW, Australia Objectives: Psychological distress is widespread after a severe traumatic brain injury (TBI). Depression tends to be the predominant presentation, with prevalence rates as high as 53% (Bombardier et al, 2010) in the first year. The pattern and course of this distress is less clear and it is important to identify critical time periods for the development of psychological disorders following TBI in order to provide treatment as early as possible. It has been suggested that emotional distress rises with increases in awareness of impairment at one year and two-three year follow ups. This study will look at the pattern of depression in a cross sectional study in the first two years after a TBI. Method: Archival data was collected from the client files of a specialist brain rehabilitation unit, providing a participant group of 504 (80.4% males, 19.4% females) with an average age of 33.1 years (range 16-71 years). Participants had experienced a severe TBI, with an average posttraumatic amnesia period of 26.8 days (range 1-183). Archival tests had been administered after participants had emerged from PTA.  Additional data collected included a measure of the psychological distress (Depression Anxiety and Stress Scale-21: DASS-21) and demographic data such as time since injury and cultural background. Data was then analysed specifically with relation to changes over time. A smaller sample of participants (N=98) were retested with the DASS-21 between 10 and 26 weeks post injury.   Results: Psychological distress demonstrated significant changes at different time periods where it decreased between months one and two, then gradually increased during the first year with a slight dip at the two year mark (χ2 range of 24.8 – 46.7, p=000). Paired sample t-test demonstrated participants (n=98) showed a significant increase in depression between two different time points range (10-26 weeks) (t=2.62, p<.01) and though an increase was evident on both stress and anxiety, it was not significant.   Conclusions: Psychological distress appears to increase over the first 12 months after a severe TBI with a slight dip at the two year time point. This suggests that early intervention for psychological distress, after emergence from PTA, maybe helpful for individuals after a TBI. Assessing awareness of impairments may further optimise the ideal time for treatment.