Depression common after traumatic brain injury
People with traumatic brain injury are three times as likely to suffer depression than the general population.
Vanderbilt researchers who analyzed studies of traumatic brain injury found that 30 percent of those patients — approximately 360,000 patients each year — also will suffer from depression after their injury.
The 2011 report, funded by the Agency for Healthcare Research and Quality, examined existing research on civilian blunt force trauma. The injuries typically happen due to car crashes, falls, assaults and sports injuries.
Traumatic brain injury injuries result in 1.2 million emergency department visits each year, with 25 percent of patients requiring hospitalization, said study co-author Oscar Guillamondegui, assistant professor in Vanderbilt’s Division of Trauma and Surgical Critical Care.
“Any patient who has a traumatic brain injury is at a real risk for developing depression, short and long term,” Guillamondegui said. “It doesn’t matter where on the timeline that you check the patient population — six months, twelve 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 findings are especially important considering that little research has been done studying whether available depression medications are safe and effective treatment for people with brain injuries.
“Even though it is possible that individuals with TBI and depression may warrant different approaches to treatment than the general population with depression, there were only two studies of treatment in this population,” said co-author Melissa McPheeters, co-director of the Vanderbilt Evidence-based Practice Center.
“It’s unacceptable,” she said, “with so many people sustaining TBIs — both in combat and civilian life — that we know so little about treating depression in this population.”
The authors said traumatic brain injury is also likely under-reported due to the high prevalence of mild injury, when patients might not go to the emergency department. (Knowing the signs of concussion in children, and what medical attention they require, is important for parents and team coaches. Concussions are brain injuries.)
“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.”
Guillamondegui said practitioners should ask about history of traumatic brain injury and follow up when they hear about symptoms such as irritability, restlessness, anxiety and sleeplessness.
Craig Boerner is media director, national news director and a senior information officer for Vanderbilt University Medical Center. This article first appeared in the Vanderbilt Reporter on April 14, 2011.