Effect of hyperbaric oxygen on the improvement of anxiety and depression after traumatic brain injury

Abstract

Objective To explore the effect of hyperbaric oxygen (HBO) on the anxiety and depression after traumatic brain injury (TBI) and optimal treatment course. Methods One hundred and five TBI patients with depression or anxiety, who either sought medical care in the outpatient or hospitalized were recruited for the study. Of all the cases, 56 were diagnosed to have anxiety, 38 have depression, and another 11 cases were diagnosed to have both anxiety and depression. The patients were divided into the HBO group and the non-HBO group, depending upon whether or not they received HBO therapy. The patients in the HBO group were those treated with HBO in our department for at least 4 weeks, while the patients in the non-HBO group were those who received medical treatment, but without HBO therapy or those who received HBO therapy for less than 1 week. Of the 105 patients, 59 received HBO therapy and 46 did not have HBO therapy. In the 67 patients with anxiety, 38 received HBO therapy, while 29 did not have HBO therapy. On the other hand, in the 49 patients with depression, 28 received HBO therapy, while 21 did not have HBO therapy. In the case of patients with anxiety, the scores of self-rating anxiety scale (SAS) and Hamilton anxiety scale (HAMA), 1, 2, 3 and 4 weeks after treatment were assessed and compared between the 2 groups. And in the case of patients with depression, the scores of self-rating depression scale (SDS) and Hamilton depression scale (HAMD) , 1, 2, 3 and 4 weeks after treatment were also assessed and compared between the 2 groups. Results For all the patients, the SAS and SDS scores of the HBO group(44.9±11.2, 36.8±14.0)4 weeks after therapy were significantly lower than those of the non-HBO group(51.7±13.9, 42.8±14.9)at the same time point (P 0.05). However, the scores of SAS and HAMA, 3 and 4 weeks after HBO therapy were significantly decreased, as compared with those of either before therapy or 1 and 2 weeks after HBO therapy. Furthermore, the scores of the HBO group were significantly lower than those of the non-HBO group, with statistical significance(P>0.05). For the patients with depression, no significant differences could be noted in the SAS and HAMA scores in the patients of the HBO group following 1 and 2 weeks after HBO therapy, when compared with those of the non-HBO group(P>0.05). However, the scores of SAS and HAMA 4 weeks after HBO therapy were significantly decreased, as compared with those 3 weeks after HBO therapy, and was significantly lower than those of the non-HBO group at the same time point, and statistical significance could be seen when comparison were made between the two(P>0.05). Conclusions HBO therapy could obviously alleviate the symptoms of the patients with anxiety and depression. However, an over 3-week treatment course was required for the patients with anxiety, and an over 4-week treatment course was mandatory for those patients with depression. Key words: Hyperbaric oxygen; Traumatic brain injury; Depression; Anxiety