Barker-Collo S, Jones A, Jones K, Theadom A, Dowell A, Starkey N, Feigin V L
School of Psychology, Faculty of Sciences, University of Auckland , New Zealand .
Brain Inj. 2015;29(7-8):859-65. doi: 10.3109/02699052.2015.1004759. Epub 2015 Apr 27.
Depression is common post-TBI, yet has not been studied longitudinally, nor at a population level. This study examined prevalence of depression in a population-based sample across the first year post-TBI.
Prospective follow-up of 315 adults (>16 years) with assessments (Hospital Anxiety Depression Scale, DSM-IV criteria) at 1-, 6- and 12-months post-TBI. Demographic and injury-related predictors of depression at 1-year post-TBI were also explored.
The number of individuals identified as depressed reduced significantly between baseline and 12-months post-TBI from 21-12.4% using the HADS and 49-34% using DSM-IV criteria; with only 10 of the 28 individuals initially meeting criteria on the HADS continuing to do so at 12-month follow-up. Meeting HADS depression criteria was linked to pre-morbid depression and/or anxiety; while those meeting DSM-IV criteria were older, but not significantly so.
The findings suggest depression is common post-TBI and that clinicians/researchers use caution in its diagnosis, as existing criteria have significant overlap with common TBI sequels.
创伤性脑损伤(TBI)后抑郁症很常见,但尚未进行纵向研究,也未在人群层面进行研究。本研究调查了TBI后第一年基于人群样本中的抑郁症患病率。
对315名成年人(>16岁)进行前瞻性随访,在TBI后1个月、6个月和12个月进行评估(医院焦虑抑郁量表,DSM-IV标准)。还探讨了TBI后1年抑郁症的人口统计学和损伤相关预测因素。
使用医院焦虑抑郁量表(HADS),在基线和TBI后12个月之间,被确定为抑郁的个体数量从21%显著降至12.4%;使用DSM-IV标准,该比例从49%降至34%;最初符合HADS标准的28名个体中,只有10名在12个月随访时仍符合标准。符合HADS抑郁标准与病前抑郁和/或焦虑有关;而符合DSM-IV标准的个体年龄较大,但差异不显著。
研究结果表明,抑郁症在TBI后很常见,临床医生/研究人员在诊断时应谨慎,因为现有标准与常见的TBI后遗症有显著重叠。