Prevalence of depression after TBI in a prospective cohort: The SHEFBIT study

Objective: The objective is to measure the prevalence of depression after traumatic brain injury (TBI) and the features associated with increased risk in a cohort that reflects clinical practice. Methods: Prospective TBI admissions to a large Teaching Hospital Emergency Department were recruited over a 2-year period. Assessments for depression and other psychosocial and global outcomes were completed at 3 months post-injury. Comparisons were made with demographic and injury features of interest to establish any associations of depression risk. Results: Out of 827 individuals, 774 (94%) successfully attended follow-up. A percentage of 56.3 had depression using a HADS-D > 8. Depressed individuals had higher levels of post-concussion symptoms and worse psychosocial and global outcome ratings. In multivariable analysis, features associated with depression were TBI severity, previous psychiatric history, alcohol intoxication at time of injury, female gender and nonwhite ethnicity. Those with a normal CT scan showed higher risk than those with only mild abnormality and were comparable to those with much more marked CT changes. Conclusion: The 3-month prevalence of depression after TBI is very high and associated with several injury and demographic features. Future long-term follow-up of this cohort aims to confirm the features that increase risk; this may allow the earlier targeting of susceptible individuals for depression interventions.