Long-Term Depression Linked to TBI

About 30 percent of traumatic brain injury (TBI) patients will develop clinical depression, a level three times higher than the general population, according to a new study from Vanderbilt University.  By examining more than 100 previously published studies done over several decades on patients that had experienced TBIs resulting from motor vehicle accidents, falls, assaults, and sports injuries, the Vanderbilt researchers were surprised to discover that the incidence of depression seems to hold steady for people with TBIs even years later.

 “Any patient who has a traumatic brain injury is at a real risk for developing depression, short and long term,” said Dr. Oscar Guillamondegui, study co-author and professor in Vanderbilt’s Division of Trauma and Surgical Critical Care. “It doesn’t matter where on the timeline that you check the patient population – six months, 12 months, two years, five years – the prevalence is always around 30 percent across the board.  In the general population about 9 percent to 10 percent of people have depression.”

 The study didn’t show a distinction between mild and severe brain injuries, meaning a patient who sustains a concussion might be just as likely to develop depression as one with a fractured skull and severe bleeding on the brain.

 “Nine months out, they may have developed depression as a result of the injury, but because the injury seemed mild they may not have had a visit with a physician who could pick up on the problem,” said study co-author, Melissa McPheeters, a health-care epidemiologist and co-director of Vanderbilt’s Evidence-based Practice Center.

 “Patients and their families need to know about this,” McPheeters said. “They need to know what to look for because they are the ones who will see the changes first.”

 The researchers also suggested that practitioners should ask about whether a patient has a history of TBI, when they are initially seen for symptoms such as irritability, restlessness, anxiety, and sleeplessness, so that both conditions can be treated together.