Research Reports - Mood disorders after traumatic brain injury
J Pediatr. 2013 Oct 8
Tsai MC, Tsai KJ, Wang HK, Sung PS, Wu MH, Hung KW, Lin SH
OBJECTIVE: To delineate the relationship between traumatic brain injury (TBI) and
mood disorders from population-based data in Taiwan.
STUDY DESIGN: This prospectively followed cohort study involved a subset of the
National Health Insurance Research Database containing complete inpatient and
outpatient data of 1 million randomly drawn beneficiaries. We included 10- to
24-year-old patients (n = 15 203) receiving the diagnosis of TBI in ambulatory
visits or hospitalization from 2000-2004 and their age- and sex-matched
comparison insureds using health service in the same year (n = 76 015). Diagnosis
of mood disorders was recorded within 5 years after the traumatic event or index
use of health service. Baseline demographics, clinical characteristics, and
premorbid psychiatric conditions were compared using χ(2) analysis. Increased
risk during the 5-year follow-up period was represented by crude and adjusted
hazard ratios with 95% CI using a Cox proportional hazard regression.
RESULTS: A total of 451/15 203 patients with TBI (2.97%) received a diagnosis of
mood disorders in the 5-year follow-up period compared with 1153/97 445
individuals (1.52%) without antecedent TBI. After adjusting for select premorbid
comorbidities, TBI remained a significant predisposing factor with a 1.96-fold
(95% CI 1.74-2.22) increase in risk of mood disorders.
CONCLUSIONS: Our findings show a higher likelihood of manifesting mood disorders
in adolescents and young adults who sustained a prior TBI. Health professionals
should carefully monitor both the physical and psychological impacts of head