Depression is associated with poorer recover after traumatic brain injury (TBI), yet awareness of depression risk post-TBI among providers and patients is low. The aim of this study was to estimate risk of depression post-TBI among adults 18 years of age and older and to identify risk factors associated with developing depression post-TBI. We conducted a retrospective, matched cohort study using claims data for privately insured and Medicare Advantage enrollees in a large U.S. health plan. Adults ≥18 years of age diagnosed with TBI (n = 207,354) with 12 months continuous insurance coverage pre-TBI and 24 months post-TBI were matched to controls without TBI (n = 414,708). We identified the presence of depression on any in- or outpatient claim occurring during the study period (both before and after TBI). Of the initial 622,062 individuals, 62,963 (10%) had depression pre-TBI and were excluded from incidence calculations. Incidence of depression post-TBI was 79.5 (95% confidence interval [CI], 78.5,80.5) per 1,000 person-years compared to 33.5 (95% CI, 33.1,34.0) per 1,000 person-years for those without TBI. The adjusted hazard ratio for depression post-TBI was 1.83 (95% CI, 1.79,1.86). We observed effect modification by sex and age, with males and older adults at increased risk. History of neuropsychiatric disturbances pre-TBI was the strongest predictor of depression post-TBI. Risk of depression increases substantially post-TBI. Groups at increased risk include those with a history of neuropsychiatric disturbances, older adults, and men. This study highlights the importance of long-term monitoring for depression post-TBI.

Objectives: Depression is a leading cause of global burden of disease. Depression in high risk group needs special attention. Depression among fathers of a newborn (Paternal Postnatal Depression) is not commonly identified as depression among mothers (Maternal Postpartum Depression) of a newborn. However, both maternal and paternal depression during postpartum period can impact child development. The aim of this study is to estimate the prevalence rate of paternal postnatal depression among fathers of a newborn in Saudi Arabia. MethOds: This is a cross-section study of fathers who received a newborn baby within 6 months at the time of participation in the survey. Participants were selected using systematic sampling of fathers visiting birth registration office. Two hundred ninety participants were screened using validated self-administered Arabic version of Edinburgh Postnatal Depression Scale (EPDS). Participants with EPDS score of 9 or above were considered to have depression. Demographic characteristics were summarized and reported in terms of mean, standard deviation and proportion. Both apparent and sensitivity/ specificity adjusted prevalence were calculated and reported in terms of point estimate and corresponding Wilson 95% confidence interval. Analyses were carried out using SAS version 9.4. Results: Among the 290 participating fathers, the average age was 34.97±8.56 years, with the reported average age of spouse was 29.18±7.41 years, and the newborns baby's age was 43.13±35.88 days. 184(73.3%) fathers had prior children and median number of children living in house was 3(3.0). 141(50.9%) fathers had higher education. 263(94.27%) were employed and 218(83.2%) reported to have full time job. Only 78(28.36%) had own a home. 261(92.55%) were married to one wife. 159(55.9%) had planned pregnancy. The overall apparent prevalence of paternal postnatal depression was 27.9%, 95% CI (23.1, 33.3). However, adjusted prevalence was 16.6%, 95% CI (8.5, 25.6). cOnclusiOns: Men mental health needs equal attention as women during and post-delivery of the newborn.