The Prevalence of Psychiatric Disorders Before and After Spinal Cord Injury: A Nationwide Population-based Longitudinal Study

e94 Main Outcome Measure(s): Functional Ambulation Category (FAC), STREAM, and PASS were used to assess the walking ability, motor function, and balance performance, respectively. Demographic data and clinical characteristics were collected. Binary logistic regression was used to identify predictors and the odd ratio. Results: Both the PASS and STREAM were significant correlated with FAC. The PASS (dynamic balance) score  16 are more likely to achieve independent walking (FAC3) (odds ratio [OD] 2.28, 95% confidence interval [CI] 1.33-3.12, high sensitivity and specificity (91.7% and 84.2%) and positive and negative predicted value (92% and 84%)). The STREAM (lower extremity) score  45 are more likely to walk independently (OD 1.15, 95% CI 1.08-1.22), high sensitivity and specificity (87.5% and 86.8%) and positive and negative predicted value (92.6% and 78.6%). Conclusions: The PASS and STREAM is a useful assessment to predict walking ability in persons with stroke in community. Key Words: Walking ability, Stroke, Balance Disclosures: None disclosed. Research Poster 623 Gender Differences in Neuropsychological Functioning Following Mild Traumatic Brain Injury: Implications for Assessment and Rehabilitation Coralynn Long (Rusk Rehabilitation), Amanda Childs, Amanda Ellois, Jacqueline Smith, Hilary Bertisch, Yvonne Lui, Joseph F. Rath Research Objectives: Women generally experience higher incidence of concussions, different and more severe postconcussive symptoms (PCS), and slower recovery. Nonetheless, the literature does not unanimously support sex-related differences in neuropsychological (NP) deficits, arguably due to a lack of consistency in objective NP measures used. The present study aims to elucidate gender differences in NP functioning, using an evidence-based test battery incorporating measures recommended by the Federal Interagency TBI Outcomes Common Data Elements (CDE) Work Group. Design: Utilize descriptive/inferential statistics to describe gender differences in outcome in individuals with mild TBI (mTBI). Setting: Academic medical center in a large metropolitan area. Participants: Individuals with mTBI (n Z 31), 52% female, primarily White (74%), average age of 35.8 (SD Z 11.4), with 16.1 years (SD Z 1.7) of education. Healthy controls (n Z 24), well matched on age, gender, race, education, and premorbid IQ. Interventions: Not Applicable. Main Outcome Measure(s): NP battery based on recommendations of the CDE Work Group, focusing on (a) neuropsychological impairment, (b) psychological status, and (c) PCS and behavioral functioning. Results: In the mTBI Group, both genders reported more PCS than controls (p’s < .05), with women reporting more behavioral dysfunction than men (p’s < .05). Using robust CDE NP measures, injured women had worse objective sensory-motor functioning, auditory working memory, visuoperceptual ability, and immediate and short-term visual memory, when compared with injured men (p’s < .05). Conclusions: Findings suggest that the lack of consensus in the literature regarding gender-differences in postconcussion neuropsychological functioning may be attributed to heterogeneity of NP tools used. The importance of using assessment batteries that incorporate robust, well-validated CDEs, implications for rehabilitation, and potential biomechanical, cultural, and hormonal explanations for gender differences in outcome will be discussed. Key Words: Mild Traumatic Brain Injury, NINDS Common Data Elements, Gender differences, Concussion, Neuropsychological assessment Disclosures: This work was supported by grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR; Rusk Advanced Rehabilitation Research Training Postdoctoral Fellowship, 90AR5014, J. Rath, Project Director) and the National Institute of Neurological Diseases and Stroke (NINDS; Quantitative MRI and 1H-MRS in Traumatic Brain Injury, R01-NS039135; Y. Lui, PI).

Research Posters Research Poster 624 The Prevalence of Psychiatric Disorders Before and After Spinal Cord Injury: A Nationwide Populationbased Longitudinal Study Po-Cheng Chen (Kaohsiung Chang Gung Memorial Hospital), Lin-Yi Wang, Yi-Jung Hsin, Ching-Hui Chuang Research Objectives: To compare the prevalence of psychiatric disorders before and after spinal cord injury (SCI). Design: Retrospective longitudinal study with multiple measures. Setting: The study was conducted using a nationally representative sample of 1 million National Health Insurance enrollees. Participants: Newly diagnosed SCI outpatients (NZ5794) during the years 2000-2009. Interventions: Not applicable. Main Outcome Measure(s): We categorized psychiatric disorders into four main disorders, including cognitive disorders, mood disorders, anxiety disorders, and trauma and stress-related disorders. The prevalence of each psychiatric disorder before and after SCI was estimated respectively. McNemar’s test was performed to compare the paired prevalence of each disorder before and after SCI. Results: There was significantly higher prevalence after SCI than before SCI in cognitive disorders (2.3% vs. 1.5%, P < 0.001), mood disorders (12.2% vs. 9.5%, P < 0.001), and anxiety disorders (22.7% vs. 18.7%, P < 0.001). Among the subgroups of cognitive disorders, the prevalence of schizophrenia and other psychotic disorders was significantly elevated after SCI (2.1% vs. 1.4%, P Z 0.001). Among the subgroups of mood disorders, the prevalence of unipolar depression and bipolar/cyclothymic disorder was significantly elevated after SCI (11.1% vs. 8.7%, P < 0.001; 1.8% vs. 1.2%, P Z 0.003, respectively). Among the subgroups of anxiety disorders, the prevalence of generalized anxiety disorder or anxiety disorder not otherwise specified was significantly elevated after SCI (22.5% vs. 18.6%, P < 0.001). Conclusions: The prevalence of schizophrenia and other psychotic disorders, unipolar depression, bipolar/cyclothymic disorder, and generalized anxiety disorder or anxiety disorder not otherwise specified tended to increase after SCI. Key Words: Spinal cord injury, psychiatric disorder, prevalence Disclosures: None disclosed. Research Poster 625 Racial-Differences in Speech-Language Pathology Utilization and Cost among Persons with Aphasia in the Stroke Belt Charles Ellis (East Carolina University), Rose Y. Hardy, Richard C. Lindrooth, Richard K. Peach Research Objectives: To examine racial differences in speech-language pathology (SLP) utilization and costs among persons with aphasia (PWA) being treatment in acute care hospitals in North Carolina (NC). Design: Secondary data analysis. NC Healthcare Cost and Utilization Project (HCUP) data from 2011-2012 were analyzed to examine SLP utilization and costs for patients with aphasia. Analyses emphasized length of stay (LOS), charges and cost of SLP services. Generalized linear models (GLM) were constructed to determine the impact of demographic characteristics, stroke severity, residence and hospital fixed effects on SLP utilization and costs. Setting: Acute care hospitals in the state of NC. Participants: Patients admitted to NC hospitals in 2011-2012 with diagnosis aphasia caused by stroke based on ICD-9 codes 784.3 (aphasia) and 434.xx, 436.xx (stroke). Interventions: Not Applicable. Main Outcome Measure(s): Length of stay and utilization of SLP services. Results: Blacks experienced 2.0 days longer LOSs than Whites after controlling for demographic characteristics, 1.2 days controlling for stroke severity and residence and .85 days controlling for hospital fixed effects. Approximately 88% of Blacks utilized SLP services compared to

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