Rajiv Singh1,2, Suzanne Mason2, Fiona Lecky2, Jeremy Dawson3. 1. a Osborn Neurorehabilitation Unit, Department of Rehabilitation Medicine , Sheffield Teaching Hospitals , Sheffield , UK. 2. b Emergency Medicine Research in Sheffield (EMRiS), School of Health and Related Research (ScHARR), Faculty of Medicine, Dentistry and Health , University of Sheffield , Sheffield , UK. 3. c Institute of Work Psychology , Sheffield University Management School , Sheffield , UK.
Abstract
OBJECTIVE: Evaluate the prevalence and risk factors for depression at 1 year after traumatic brain injury (TBI) and contrast against those at 10 weeks. METHODS: Prospective TBI admissions over 2 years to an emergency department were recruited to form a representative TBI population. Depression was recorded at 10 weeks and 1 year by HADS (Hospital Anxiety and Depression Scale) with score>8. Demographic and injury features were analyzed for association with depression. RESULTS: A total of 774 individuals were recruited of whom 690 attended 1-year follow-up; 38 had died. Only 6% of the cohort was lost to follow-up. The prevalence of depression at 10 weeks was 56.3% [95% CI 52.8-59.8] and at 1 year 41.2% [95% CI 37.6-44.9] A multivariable analysis identified the independent predictors of 1 year depression as an abnormal CT scan, past psychiatric history, alcohol intoxication, and female gender. TBI severity, age, etiology, and medical comorbidity were not significant. By contrast at 10weeks, increasing severity and CT findings were highly significant. CONCLUSIONS: Depression at 1 year post-TBI remains high but injury features are less predictive than early after injury. It is likely that pre-injury personality and coping mechanisms are more important in determining long term outcome. The predictors identified may allow targeting of vulnerable sub-populations.
OBJECTIVE: Evaluate the prevalence and risk factors for depression at 1 year after traumatic brain injury (TBI) and contrast against those at 10 weeks. METHODS: Prospective TBI admissions over 2 years to an emergency department were recruited to form a representative TBI population. Depression was recorded at 10 weeks and 1 year by HADS (Hospital Anxiety and Depression Scale) with score>8. Demographic and injury features were analyzed for association with depression. RESULTS: A total of 774 individuals were recruited of whom 690 attended 1-year follow-up; 38 had died. Only 6% of the cohort was lost to follow-up. The prevalence of depression at 10 weeks was 56.3% [95% CI 52.8-59.8] and at 1 year 41.2% [95% CI 37.6-44.9] A multivariable analysis identified the independent predictors of 1 year depression as an abnormal CT scan, past psychiatric history, alcohol intoxication, and female gender. TBI severity, age, etiology, and medical comorbidity were not significant. By contrast at 10weeks, increasing severity and CT findings were highly significant. CONCLUSIONS:Depression at 1 year post-TBI remains high but injury features are less predictive than early after injury. It is likely that pre-injury personality and coping mechanisms are more important in determining long term outcome. The predictors identified may allow targeting of vulnerable sub-populations.
Authors: Sascha Halvachizadeh; Henrik Teuber; Till Berk; Florin Allemann; Roland von Känel; Boris Zelle; Paolo Cinelli; Hans-Christoph Pape; Roman Pfeifer Journal: PLoS One Date: 2020-05-04 Impact factor: 3.240
Authors: Lukas Leitner; Jasmin Helena El-Shabrawi; Gerhard Bratschitsch; Nicolas Eibinger; Sebastian Klim; Andreas Leithner; Paul Puchwein Journal: Arch Orthop Trauma Surg Date: 2020-07-23 Impact factor: 3.067