Depression Treatment Preferences After Traumatic Brain Injury

Objective: To determine preferences for depression treatment modalities and settings among persons with traumatic brain injury (TBI). Design: Telephone survey. Depression status was determined using the Patient Health Questionnaire-9. Setting: Harborview Medical Center, Seattle, Washington, the level I trauma center serving Washington, Idaho, Montana, and Alaska. Participants: One hundred forty-five adults, English-speaking consecutive patients admitted with complicated mild to severe TBI. Main Outcome Measures: Telephone survey within 12 months post-TBI ascertaining preferences for depression treatment modalities and settings. Results: More patients favored physical exercise or counseling as a depression treatment than other treatment modalities. Group therapy was the least favored modality. Patients favored speaking with a clinician in the clinic or over the telephone and were less likely to communicate with a clinician over the Internet. Subjects with probable major depression or a history of antidepressant use or outpatient mental health treatment were more likely to express a preference for antidepressants for treatment of depression. Conclusions: This study underscores the importance of understanding patient preferences and providing patient education in selecting a treatment for depression after TBI. Future studies should examine psychotherapy and alternative treatment modalities and delivery models for the management of depression in this vulnerable population.