Major and Minor Depression After Traumatic Brain Injury
At one year after TBI, how many people report minor or major depression and how is depression related to other outcomes?
Past studies of persons with TBI have looked at major depression only. Studies with other clinical groups have found that people tend to experience both minor and major depression at different points in time. Minor depression may be an early warning of major depression. Minor depression is also associated with reduced quality of life.
This study looked at predictors of depression one year after moderate-severe TBI, and the relationship between minor and major depression, participation in the community, physical and cognitive disability, and satisfaction with life. Of the 1570 participants, twenty-two percent reported minor depression and 26% reported major depression. Depression was more likely in people who were younger and/or female, who had a history of mental health or substance abuse problems prior to the injury, and who had sustained an intentional injury (e.g. suicide attempt). Increasing severity of depression was associated with increased disability, lower satisfaction with life, and less participation in the community.
The study results may not apply to people who are not able to provide self-report, or to people who did not receive inpatient TBI rehabilitation. This study may underestimate the rate of depression because some of those at-risk for depression were lost to follow-up.
Even symptoms of depression that are below the threshold for major depression are associated with poor outcomes. Researchers and clinicians should attend to symptoms of depression even if criteria for major depression are not met.
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Hart, T., Brenner, L., Clark, A., Bogner, J., Novack, T., Chervoneva, I., Richardson, R., Arango-Lasprilla. Major and minor depression following traumatic brain injury. Archives of Physical Medicine and Rehabilitation, in