Research Reports - Depression following traumatic brain injury

Neurosci Biobehav Rev. 2014 Jul 16

Osborn AJ(1), Mathias JL(2), Fairweather-Schmidt AK(3)

BACKGROUND: Depression is one of the most frequently reported psychological
problems following TBI, however prevalence estimates vary widely. Methodological
and sampling differences may explain some of this variability, but it is not
known to what extent.
METHODS: Data from 99 studies examining the prevalence of clinically diagnosed
depression (MDD/dysthymia) and self-reports of depression (clinically significant
cases or depression scale scores) following adult, non-penetrating TBI were
analysed, taking into consideration diagnostic criteria, measure, post-injury
interval, and injury severity.
RESULTS: Overall, 27% of people were diagnosed with MDD/dysthymia following TBI
and 38% reported clinically significant levels of depression when assessed with
self-report scales. Estimates of MDD/dysthymia varied according to diagnostic
criteria (ICD-10: 14%; DSM-IV: 25%; DSM-III: 47%) and injury severity (mild: 16%;
severe: 30%). When self-report measures were used, the prevalence of clinically
significant cases of depression differed between scales (HADS: 32%; CES-D: 48%)
method of administration (phone: 26%; mail 46%), post-injury interval (range:
33-42%), and injury severity (mild: 64%; severe: 39%).
CONCLUSION: Depression is very common after TBI and has the potential to impact
on recovery and quality of life. However, the diagnostic criteria, measure, time
post-injury and injury severity, all impact on prevalence rates and must
therefore be considered for benchmarking purposes.

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