Sunnybrook Health Sciences Centre, Geriatric Traumatic Brain Injury Clinic, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
CNS Drugs. 2012 Feb 1;26(2):111-21. doi: 10.2165/11599560-000000000-00000.
It is important for clinicians to recognize major depression following traumatic brain injury (TBI) because of its association with poor global and psychosocial outcome, postconcussive symptoms and cognitive deficits. The purpose of this review is to provide an up-to-date selective review of the current understanding of epidemiology, risk factors and management of major depression following TBI. Many studies of prevalence of depression following TBI have not used accepted structured criteria for the diagnoses, but those that did found wide ranges of rates, from 17% to 61%. The risk factors for development of depression following TBI are poorly understood, but past psychiatric history, frontal lesions and atrophy, and family dysfunction have been shown in more than one study to play important roles. There are few controlled trials of the treatment of major depression in patients with TBI using accepted diagnostic criteria for major depression, as well as defined criteria for response and remission. As such, it is important for clinicians to use best practice guidelines for the treatment of major depression in the absence of TBI.
对于临床医生来说，识别创伤性脑损伤（TBI）后的重度抑郁症非常重要，因为它与较差的整体和社会心理预后、脑震荡后症状和认知缺陷有关。本综述的目的是提供目前对 TBI 后重度抑郁症的流行病学、危险因素和治疗的最新选择性综述。许多关于 TBI 后抑郁患病率的研究没有使用公认的结构化标准进行诊断，但那些确实发现了广泛的发病率，从 17%到 61%不等。TBI 后发生抑郁症的危险因素尚不清楚，但过去的精神病史、额叶病变和萎缩以及家庭功能障碍在不止一项研究中被证明起着重要作用。使用公认的重度抑郁症诊断标准以及明确的反应和缓解标准，对 TBI 患者进行重度抑郁症治疗的对照试验很少。因此，在没有 TBI 的情况下，临床医生使用重度抑郁症治疗的最佳实践指南非常重要。
