Departments of Psychiatry and Behavioral Sciences (Roy, Yan, Leoutsakos, Rao, Peters) and Physical Medicine and Rehabilitation (Bechtold), Johns Hopkins University, Baltimore; Department of Pharmacology and Physiology, Georgetown University, Washington, DC (Ghosh); ImmunArray, Inc., Richmond, Virginia (Van Meter); University of Michigan Medical School, Ann Arbor (Falk, Korley).
J Neuropsychiatry Clin Neurosci. 2022 Fall;34(4):367-377. doi: 10.1176/appi.neuropsych.21080207. Epub 2022 Mar 21.
Depressive symptoms are among the most common neuropsychiatric sequelae of mild traumatic brain injury (mTBI). Very few studies have compared correlates of depressive symptoms within the first 6 months of injury in cohorts experiencing their first TBI. The authors investigated whether the correlates of depressive symptoms (being female, older, lower education, having brain lesions, experiencing worse postconcussive symptoms, and incomplete functional recovery) that have been established in populations with moderate to severe TBI were the same for individuals with first-time mTBI within the first 6 months of recovery.
Two hundred seventeen individuals with first-time mTBI were divided into subgroups-new-onset depressive symptoms, recurrent depressive symptoms, prior depression history only, and never depressed-and compared on clinical and demographic variables and the presence of postconcussive symptoms and functional recovery at 3 and 6 months.
New-onset depressive symptoms developed in 12% of the cohort, whereas 11% of the cohort had recurrent depressive symptoms. Both depressive symptoms groups were more likely to comprise women and persons of color and were at higher risk for clinically significant postconcussive symptoms and incomplete functional recovery for the first 6 months postinjury.
Presence of depressive symptoms after first-time mTBI was associated with persistent postconcussive symptoms and incomplete functional recovery in the first 6 months. Adding to the existing literature, these findings identified correlates of depressive symptom development and poor outcomes after mTBI, thus providing further evidence that mTBI may produce persistent symptoms and functional limitations that warrant clinical attention.
抑郁症状是轻度创伤性脑损伤（mTBI）后最常见的神经精神后遗症之一。在首次发生 TBI 的队列中，很少有研究比较损伤后 6 个月内抑郁症状的相关性。作者研究了在中重度 TBI 人群中确定的抑郁症状相关性（女性、年龄较大、教育程度较低、有脑损伤、经历更严重的脑震荡后症状和功能恢复不完全）是否与首次 mTBI 后 6 个月内的个体相同。
将 217 名首次 mTBI 患者分为新发抑郁症状亚组、复发性抑郁症状亚组、既往抑郁病史亚组和从未抑郁亚组，并比较 3 个月和 6 个月时的临床和人口统计学变量以及脑震荡后症状和功能恢复情况。
12%的队列出现新发抑郁症状，11%的队列出现复发性抑郁症状。两组抑郁症状患者更有可能是女性和有色人种，并且在伤后前 6 个月内更有可能出现临床显著的脑震荡后症状和功能恢复不完全。
首次 mTBI 后出现抑郁症状与前 6 个月持续存在的脑震荡后症状和功能恢复不完全有关。这些发现增加了现有文献的内容，确定了 mTBI 后抑郁症状发展和不良结局的相关性，从而进一步证明 mTBI 可能产生持续的症状和功能限制，需要临床关注。
