Depression in Men and Women One Year Following Traumatic Brain Injury (TBI): A TBI Model Systems Study

Abstract

In the general population, females experience depression at significantly higher rates than males. Individuals with traumatic brain injury (TBI) are at substantially greater risk for depression compared to the overall population. Treatment of, and recovery from, TBI can be hindered by depression; comorbid TBI and depression can lead to adverse outcomes and negatively affect multiple aspects of individuals’ lives. Gender differences in depression following TBI are not well understood, and relevant empirical findings have been mixed. Utilizing the Patient Health Questionnaire-9 (PHQ-9) 1 year after TBI, we examined whether women would experience more severe depressive symptoms, and would endorse higher levels of depression within each category of depression severity, than would men. Interestingly, and contrary to our hypothesis, men and women reported mild depression at equal rates; PHQ-9 total scores were slightly lower in women than in men. Men and women did not differ significantly in any PHQ-9 depression severity category. Item analyses, yielded significant gender differences on the following items: greater concentration difficulties (cognitive problems) in men and more sleep disturbances (psychosomatic issues) in women per uncorrected two-sample Z-test for proportions analyses; however, these results were not significant after the family-wise Bonferroni correction. Our results indicate that, in contrast to the general population, mild depression in persons with moderate to severe TBI may not be gender-specific. These findings underscore the need for early identification, active screening, and depression treatment equally for men and women to improve emotional well-being, promote recovery, and enhance quality of life following TBI.

The effect of time on cognitive impairments after non-traumatic subarachnoid haemorrhage and after traumatic brain injury

“…However, in our study sample, HADS anxiety or depression scores did not change significantly between the consecutive time points or over the total observation period from 3 to 12 months after SAH or TBI and we observed no obvious correlations between BNIS T scores and HADS scores. At 12 months, approximately one fifth of patients in both groups fulfilled criteria for depression or anxiety, which is in accordance with previous studies (66)(67).…”

Microglial Phagocytosis of Neurons: Diminishing Neuronal Loss in Traumatic, Infectious, Inflammatory, and Autoimmune CNS Disorders

“…Impaired neuronal function (1–4), from neuroinflammation or other causes, is a known driver of depression and related neuropsychiatric problems (5–11) that often accompany complex CNS disorders, including TBI (12, 13) and CNS disorders with autoimmune components (14), such as multiple sclerosis (MS) (15, 16), Parkinson’s disease (PD) (17–19), and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS)/Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) (20). A recent twin study by Huang, et al, suggests that the causal connection between depression and neuroinflammation may be bidirectional.…”

Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review

“…As such, it is important to consider the death rates among the general population when examining the influence of TBI and other conditions on mortality. While sex and gender had been known to show an influence on post-TBI recovery, such as functional and cognitive outcomes,53 54 findings within the included studies were mixed, which is in line with the current lack of consensus on this topic. Additional demographic variables, such as race, marital status, employment status, rurality and insurance status, were also examined.…”