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The Clinical Significance of Major Depression Following Mild Traumatic Brain Injury

Presented in part at the 13th annual meeting of the American Neuropsychiatric Association, La Jolla, Calif., March 10–12, 2002. Received Dec. 14, 2001; revision received April 26, 2002; accepted May 16, 2002. From the Department of Psychiatry and Traumatic Brain Injury Clinic, Sunnybrook and Women's College Health Sciences Centre, University of Toronto; and the Kunin-Lunenfeld Applied Research Centre, Baycrest Centre for Geriatric Care, University of Toronto, Toronto. Address reprint requests to Dr. Rapoport, FG37, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Ave., Toronto, Ont. M4N 3M5, Canada.

OBJECTIVE: The authors assessed the association of major depression with behavioral outcome following mild traumatic brain injury. METHOD: Consecutive patients with mild traumatic brain injury (N=170) were assessed for major depression. Those with major depression were compared with those without on self-report measures of psychosocial dysfunction, psychological distress, and postconcussive symptoms in addition to examiner-rated neurobehavioral disturbance. RESULTS: Major depression was seen in 15.3% (N=26) of the subjects after traumatic brain injury, and these individuals showed subjective and objective evidence of poorer outcome. CONCLUSIONS: Major depression is associated with poor outcome across multiple domains. This study highlights the need for the early diagnosis and prompt treatment of major depression following mild traumatic brain injury.

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