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.