{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:02:35Z","timestamp":1785132155600,"version":"3.55.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"7-8","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:p>\n                    Traumatic brain injury (TBI) is common, disabling, and a growing public health concern. There are limited large-scale studies providing insight into factors associated with recovery in the general TBI population. Our aim was to identify factors associated with concussion\/TBI symptom severity and return-to-work. We performed a prospective cohort study of concussion\/TBI (predominantly mild to moderate) patients with data collected over a 20-year period (1998\u20132018). This is the first study presenting data from the Sunnybrook TBI (SUNTBI) cohort. Primary outcome at approximately 3-month postinjury was the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), and secondary outcome was return-to-work. Outcomes were analyzed using multivariable linear regression and logistic regression models, respectively. There were 2924 TBI patients included in the study. General Health Questionnaire (GHQ), a screening measure of current psychiatric symptoms, and all its subscales (depression, anxiety, somatic, and social) (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.0001), and active litigation (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001) were significantly associated with higher RPQ scores. Notably, factors related to injury characteristics and severity were not (e.g., injury mechanism, TBI severity, and neuroimaging abnormalities). For return-to-work, having a professional occupation (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001) was significantly positively associated with return, while abnormal CT scan (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.001), admission to hospital (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001), and higher GHQ score (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001) were negatively associated. In one of the largest observational studies of general population concussion\/TBI patients to date, we found that psychiatric symptoms and litigation status were significantly associated with symptoms at 3 months, while factors related to the injury severity were not. We also observed a decoupling of factors that impact symptom score outcomes from return-to-work outcomes. These results have important implications for the management of at-risk TBI subpopulations and wider public policy considerations.\n                  <\/jats:p>","DOI":"10.1177\/08977151251394006","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:40:02Z","timestamp":1762821602000},"page":"618-624","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Three-Month Outcomes of Traumatic Brain Injury in the General Population: A Sunnybrook Traumatic Brain Injury Cohort Study"],"prefix":"10.1177","volume":"43","author":[{"given":"Robert J.","family":"Ure","sequence":"first","affiliation":[{"name":"Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Kiss","sequence":"additional","affiliation":[{"name":"Hurvitz Brain Sciences Program and Tory Trauma Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Mikoli\u0107","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of British Columbia, Vancouver, Canada."},{"name":"Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke","family":"McLellan","sequence":"additional","affiliation":[{"name":"Neuropsychiatry Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah D.","family":"Silverberg","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of British Columbia, Vancouver, Canada."},{"name":"Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Feinstein","sequence":"additional","affiliation":[{"name":"Hurvitz Brain Sciences Program and Tory Trauma Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada."},{"name":"Neuropsychiatry Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Burke","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada."},{"name":"Neuropsychiatry Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000156"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00002-2"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.24095\/hpcdp.38.3.05"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2013.08.299"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2020.7074"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2014.3600"},{"issue":"2","key":"e_1_3_3_8_2","first-page":"74","article-title":"The General Health Questionnaire (GHQ): a comprehensive review","volume":"14","author":"Vieweg BW","year":"1983","unstructured":"Vieweg BW, , Hedlund JL. 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