Predictors of depression after traumatic brain injury

Archives of Clinical Neuropsychology -


Donders, J. and E. Bay.



Objective: The purpose of this investigation was to determine the prevalence of depression after mild-moderate traumatic brain injury (TBI) and to identify which premorbid and concurrent factors predicted such depression. Method: Sixty community-dwelling adult patients (52% male, 85% Caucasian; all hospitalized for TBI, with Glasgow Coma Scale scores ranging from 9 to 15) were recruited from various outpatient treatment programs. They completed the Neurobehavioral Function Inventory (NFI), Perceived Stress Scale (PSS), Impact of Events Scale (IES), Fatigue Impact Scale (FIS), McGill Pain Questionnaire (MPQ), and the IMPACT computerized cognitive battery within 1–3 years after injury. Results: Sixty percent of the sample was identified as meeting NFI criteria for depression. Hierarchicalregression analyses indicated that fatigue (FIS), pain (MPQ), and longstanding chronic stress (PSS) were statistically significant predictors of depression after TBI (p < 0.01 for all three variables). However, the total amount of variance accounted for was modest (R2 = 0.16). In contrast, neither stress selectively related to the event of the TBI (IES), nor current cognitive status (IMPACT), were statistically significant predictors (p > 0.10). Conclusion: Depression is common after TBI and is predicted at least in part by a combination of premorbid psychosocial stressors and post-morbid pain and fatigue. The superimposition of mild-moderate TBI on chronic, pre-existing stress appears to be the relatively biggest risk factor in this regard.

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