Singh Rajiv, Mason Suzanne, Lecky Fiona, Dawson Jeremy
a Osborn Neurorehabilitation Unit, Department of Rehabilitation Medicine , Sheffield Teaching Hospitals , Sheffield , UK.
b Emergency Medicine Research in Sheffield (EMRiS), Health Services Research , School of Health and Related Research (ScHARR) University of Sheffield , UK.
Brain Inj. 2018;32(1):84-90. doi: 10.1080/02699052.2017.1376756. Epub 2017 Nov 30.
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.
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.
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.
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.
目的是在一个反映临床实际情况的队列中，测量创伤性脑损伤（TBI）后抑郁症的患病率以及与风险增加相关的特征。
在两年时间内，招募前瞻性入住一家大型教学医院急诊科的TBI患者。在受伤后3个月完成抑郁症及其他心理社会和整体结局的评估。将这些结果与感兴趣的人口统计学和损伤特征进行比较，以确定抑郁症风险的任何关联。
827名个体中，774名（94%）成功接受了随访。使用医院焦虑抑郁量表-抑郁（HADS-D）评分>8时，抑郁症患病率为56.3%。抑郁个体的脑震荡后症状水平更高，心理社会和整体结局评分更差。在多变量分析中，与抑郁症相关的特征包括TBI严重程度、既往精神病史、受伤时酒精中毒、女性性别和非白人种族。CT扫描正常的患者比仅有轻度异常的患者风险更高，且与CT改变更明显的患者相当。
TBI后3个月抑郁症患病率非常高，且与多种损伤和人口统计学特征相关。该队列未来的长期随访旨在确认增加风险的特征；这可能有助于更早地针对易患抑郁症的个体进行干预。
