Depression following traumatic brain injury and the Hamilton Depression Rating Scale.

摘要

This study examined manifestations of depressive symptoms across two years following traumatic brain injury (TBI) in a sample of U.S. military and veteran patients admitted to inpatient TBI units in Minneapolis, Tampa, Richmond, and Palo Alto between 1993 and 2000. Participants were assessed for depressive symptoms at baseline, one year, and two years post-TBI. The relationships between demographic and clinical variables, including age, race, education, marital status, gender, severity of loss of consciousness, severity of posttraumatic amnesia, and type of head injury, and depression were also examined. Participants' ages ranged from 17 to 78 years. Four samples were examined. At baseline, 886 males and 110 females were randomized into the study. At one-year post-TBI, 331 males and 39 females were assessed for depression. At two years post-TBI, 208 males and 20 females were assessed for depression. The fourth sample consisted of 116 participants (103 males and 13 females) who were tested at all three time intervals. The outcome measure used in the current investigation of depression was the Hamilton Depression Rating Scale (HDRS). Length of loss of consciousness and posttraumatic amnesia were measured in days, hours, and minutes and converted to Likert rating scales of severity. Demographic information was gathered from medical records. Data were analyzed using multiple regression, ANOVAs, and principle components analysis. This study revealed variability of depression course; both transient and chronic depression was found following TBI. Demographic variables were unhelpful in significantly predicting who would become depressed. A general anxious depression factor was found for the HDRS. An unstable and variable factor for the HDRS was also found across assessment intervals.