The prevalence and symptom rates of depression after traumatic brain injury: a comprehensive examination

Primary objective: Differing definitions of depression, limited sample sizes, and variability in methodologies have contributed to equivocal findings about the prevalence of depression among persons with traumatic brain injury. The present investigation used standardized diagnostic criteria and a large sample to identify the manifestations of depression after TBI. Methods and procedures: 722 outpatients with brain injury, referred for comprehensive assessment at a regional Level I trauma centre, were studied. Depressive symptoms were characterized utilizing standard DSM-IV criteria and the Neurobehavioural Functioning Inventory. Results: Forty-two per cent of patients with brain injury met the prerequisite number of symptoms for a DSM-IV diagnosis of major depressive disorder. Fatigue (46%), frustration (41%), and poor concentration (38%) were the most commonly cited manifestations of depression. Conclusions: Many patients with brain injury are at great risk for developing depressive disorders. Future research should focus on prognostic factors, developing protocols for identification of high risk patients, and examining the efficacy of treatment interventions.