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Comment & Response |

Rehabilitation and Causes of Premature Mortality in Patients With Traumatic Brain Injury

W. Shane Journeay, MD, PhD1; Shannon L. MacDonald, MD, MSc1; Mark T. Bayley, MD, FRCPC1
[+] Author Affiliations
1Division of Physical Medicine and Rehabilitation, Toronto Rehabilitation Institute and University Health Network, University of Toronto, Toronto, Ontario, Canada
JAMA Psychiatry. 2014;71(7):839-840. doi:10.1001/jamapsychiatry.2014.373.
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To the Editor We read with great interest the article by Fazel et al,1 which examined premature mortality in patients with traumatic brain injury (TBI). We commend the authors for highlighting that TBI is a chronic disease and that the long-term sequelae of TBI include premature mortality as a result of injuries (vehicle and nonvehicle), suicide, assault, and other causes.

While the authors discussed a number of factors that could influence the premature mortality in this population, including psychiatric comorbidity and co-occurring injuries, they neglected to mention the role of TBI rehabilitation. Thus, we are seeking to (1) clarify whether the patients in this study received rehabilitation and, if so, the intensity and duration and (2) highlight the important role of rehabilitation in the long-term outcomes of TBI. Indeed there is well-established evidence that interdisciplinary rehabilitation has a positive impact on functional outcomes and safe return to the community.2

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July 1, 2014
Seena Fazel, MBChB, MD; Paul Lichtenstein, PhD; Niklas Långström, PhD
1Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, England
2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
JAMA Psychiatry. 2014;71(7):840. doi:10.1001/jamapsychiatry.2014.691.
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