Association of Depressive Symptoms With Functional Outcome After Traumatic Brain Injury

Abstract

Objective-To test whether improved functional status correlates with more depressive symptoms following traumatic brain injury (TBI). This is based on the concept that increasing awareness of deficits may exacerbate depression, even while survivors are making functional improvements.Setting-Discharge from private or public hospital in major metropolitan area.Participants-471 individuals with TBI (72 % Caucasian; 71% male; median Glasgow Coma Scale score =11; median follow-up period = 6 months). Main Measure-Beck Depression Inventory-II (BDI-II), Glasgow Outcome Scale-Extended (GOS-E), Functional Status Examination (FSE)Results-We found significant Spearman's rank order correlations between BDI-II scores and the total FSE as well as all domains of the FSE. Lower functional levels correlated with more depressive symptoms. Modeling of predictive factors, including subject characteristics, injury related characteristics and outcome measures, resulted in 2 models, both containing age and GCS along with other factors. Conclusion-The relation between depressive symptoms and functional outcomes is complex and a fertile area for further research. The authors would encourage clinicians to monitor patients for depressive symptoms to help prevent the detrimental impact on recovery.

Mindful Creativity Scale (MCS): Validation of a German version of the Langer Mindfulness Scale with patients with severe TBI and controls

“…headaches [18]), sleep problems [19], behavioural problems (e.g. substance use [20]), depression [21,22], post-traumatic stress disorder [23], poor vocational outcomes [24] and often loss of 'self' [25]. McMillan et al [26] investigated mindfulness training among patients with severe TBI to help sustain attention.…”

Strategy‐based reasoning training modulates cortical thickness and resting‐state functional connectivity in adults with chronic traumatic brain injury

“…TBI is heterogeneous in terms of causes of injuries (e.g., blast, fall, sports related, blunt, and combinations thereof), locations of injuries, and injury types (Saatman et al., 2008). Furthermore, individuals with TBI frequently have comorbid psychiatric conditions such as depression and posttraumatic stress disorder (PTSD) (Ashman et al., 2004; Hibbard, Uysal, Kepler, Bogdany, & Silver, 1998; van Reekum, Bolago, Finlayson, Garner, & Links, 1996), and this comorbidity affects the brain and neuropsychological performance (Han, Chapman, & Krawczyk, 2015; Hudak, Hynan, Harper, & Diaz‐Arrastia, 2012; Hudak et al., 2011; Lindemer, Salat, Leritz, McGlinchey, & Milberg, 2013; Lopez et al., 2016; Spielberg, McGlinchey, Milberg, & Salat, 2015), exacerbating the heterogeneity challenge. Accordingly, behavioral performance of individuals with TBI, measured by neuropsychological tests, is heterogeneous (Goldstein, Allen, & Caponigro, 2010; Tellier et al., 2009; Thaler et al., 2013).…”

Cortisol Supplement Combined with Psychotherapy and Citalopram Improves Depression Outcomes in Patients with Hypocortisolism after Traumatic Brain Injury

“…However, the relationship between depressive symptoms and severity of TBI or recovery after TBI are uncertain [15]. Mixed results of a positive link, no relationship, or an inverse link between TBI severity and depressive symptoms have been published by previous studies [6,9,13,16].…”