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Major Depression Prevalent After Traumatic Brain Injury

Predicts poorer health-related quality of life; prior depression history linked to higher risk

TUESDAY, May 18 (HealthDay News) -- Within the first year after traumatic brain injury (TBI), more than half of patients meet criteria for major depressive disorder (MDD), which independently predicts poorer health-related quality of life, according to research published in the May 19 issue of the Journal of the American Medical Association.

Charles H. Bombardier, Ph.D., of the University of Washington School of Medicine in Seattle, and colleagues conducted a cohort study of 559 consecutively hospitalized patients with complicated mild to severe TBI. Patients were followed-up with periodic questionnaire assessments.

During the first year after TBI, 53.1 percent met the criteria for MDD at least once. Several factors were associated with a greater risk of MDD during this time period, including presence of MDD prior to the brain injury (but not at the time of injury), presence of MDD at the time of the injury, age and a history of alcohol dependence. Those with MDD also were more likely to have anxiety disorders after TBI than were those who did not have MDD after TBI (risk ratio, 8.77). Less than half of those with MDD after TBI received treatment for their depression. After the researchers adjusted for predictors of MDD, they found that individuals with MDD reporter lower quality of life than those without MDD.

"Because MDD after TBI is an invisible disorder within an often invisible injury, aggressive efforts are needed to educate clinicians about the importance of MDD in this population, to promote integrated systems of detection and multidisciplinary care, and to conduct intervention studies aimed at overcoming multiple barriers to effective treatment," the authors write.

Many of the study authors reported financial relationships with the pharmaceutical industry.

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