Research Reports - Relationship of preinjury depressive symptoms to outcomes mild traumatic brain injury

Am J Phys Med Rehabil. 2014 Apr 16

Kumar RG(1), Bracken MB, Clark AN, Nick TG, Melguizo MS, Sander AM

OBJECTIVE: This study examines the effect of preinjury depressive symptoms on
outcomes 3 mos after complicated and uncomplicated cases of mild traumatic brain
injury.
DESIGN: Preinjury depressive symptoms, experienced in the 30 days before injury,
as measured by retrospective self-report, were assessed within the first 2 wks
after injury. The outcome measures assessed at 3 mos after injury included
affective/behavioral, cognitive, and physical problems and health-related
quality-of-life.
RESULTS: There were 177 patients who completed both the baseline and 3-mo
follow-up interviews. The sample was categorized by severity of depressive
symptoms in the month before injury as normal, mild, or moderate-severe. Compared
with those reporting no preinjury depressive symptoms, persons reporting
moderate-severe depressive symptoms had significantly worse outcomes on the
Affective and Behavioral and the Cognitive subscales of the Head Injury-Family
Interview Problem Checklist and on the 36-item Short-Form Health Survey Mental
Component Summary score. The group reporting mild preinjury depressive symptoms
scored worse on a measure of cognitive symptoms compared with those with no
preinjury depressive symptoms. There was no interaction between preinjury
depressive symptoms and severity of the mild traumatic brain injury (complicated
or uncomplicated) for any of the outcomes.
CONCLUSION: Moderate to severe depressive symptoms in the month before injury
seems to be a possible risk factor for poor affective/behavioral, cognitive, and
mental health-related quality-of-life outcomes at 3 mos after mild traumatic
brain injury. Clinicians and researchers should consider the impact of preinjury
depression on the recovery process to provide at-risk patients adequate treatment
soon after injury.

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