Abstract
Objective: To identify variables related to posttraumatic brain injury (TBI) depression at 2 different time-points and to examine differences between individuals with TBI whose depressive symptoms persisted and those whose depressive symptoms remitted overtime. Design: Retrospective, observational study. Setting: Research center at medical center. Participants: 259 individuals with TBI (53% male; mean age ± SD, 42.5±14.9; average time ± SD since injury, 2±1.4y; severity=mild to severe). Interventions: Not applicable. Main Outcome Measures: Structured interview assessing social, occupational, and health outcomes post-TBI. Beck Depression Inventory (BDI): self-report measure assessing affective and somatic symptoms of depression. Brain Injury Screening Questionnaire (BISQ): structured self-report assessment of functional difficulties commonly experienced by individuals who have sustained a TBI. Results: The BDI was administered at 2 time-points, approximately 1 year apart. 259 participants completed the BDI at T1 and 174 participants at T2. Scores on the BDI at T1 and T2 were highly correlated (r=.80). In addition, scores on the BDI were related to income, and physical, cognitive, and behavioral symptoms related to TBI both at T1 and T2 (P<.05). When assessing changes in symptom report on the BDI over time, among individuals who scored in the moderate/severe range at T1, 13% remained in this range (maintainers) and 6% fell in the minimal/mild range at T2 (remitters). Multivariate analysis of variance indicated significant differences in physical, cognitive, and behavioral symptoms reported at T2 between maintainers and remitters. The effect was stronger for differences in self-reported behavioral symptoms (d=.20). Conclusions: Variables related to post-TBI depression remained important 1 year later. The results could be attributed to the similarity between the self-report instruments or it could reflect the existence of factors that relate to experiencing persistent symptoms of depression.
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