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Research

TBI Model Systems

Levels of Depression for Outpatients with Traumatic Brain Injury
The Question: What is the rate and level of depression for individuals with traumatic brain injury in an outpatient rehabilitation setting?

Past Studies show that some individuals develop depression after experiencing a traumatic brain injury. Depression is a real medical condition that can be treated. Depression is not a “normal part” of every day life. Persons with depression report that they continually feel sad, irritable, tired, and uninterested in activities that they used to find enjoyable. Other common symptoms of depression include having difficulty getting a good night’s sleep, moving the body at a much slower pace, and not being able to remember things or concentrate as easily as before. Past studies about traumatic brain injury and depression have not had consistent results.

This Study examined the level of depression for 41 individuals with traumatic brain injury at one outpatient rehabilitation setting. Twenty-three (56%) of the participants had received mild traumatic brain injuries and 18 (44%) of the participants had received injuries in the moderate to severe range. Individuals with mild traumatic brain injury tended to be older, and those with moderate to severe traumatic brain injuries were younger. The majority of the participants were 43 years old. Although the amount of time since their injuries ranged from about 4 months to over 21 years, it had been approximately 41 months since most of the individuals had received their brain injuries. Approximately one third of the group was taking prescription anti-depressant or stimulant medication. The participants were evaluated using the Beck Depression Inventory-II (BDI-II), an assessment instrument that rates the severity level of a depression, but is not generally used to diagnose depression.

The researchers found that 10 of the 41 participants’ BDI-II scores indicated that they had a mild level of depression. Fourteen of the participants were identified as having moderate to severe levels of depression. Overall, a total of 24 of the 41 participants (59%) were found to have mild to severe levels of depression per the BDI-II. Individuals with depression were most likely to be older females with a mild traumatic brain injury who were taking anti-depressant medication. This study did not find that violent-related traumatic brain injuries were associated with depression, as previous studies had. The authors caution that there were so few individuals with violent-related traumatic brain injuries in this study, that their finding should be interpreted with caution.

Who May Be Affected By These Findings: Persons with traumatic brain injury, their family and friends, health care providers, health care funders, and researchers

Caveats: The researchers state the results of this study should be viewed with caution. This study used a small sample size of people who were older, who had experienced their brain injury over a wide range of time (4 months to 21 years), and had some members who were taking medication for psychological disorders. Additionally, the assessment used, the BDI-II, is not typically used to diagnose depression, but to measure the levels of depression in individuals. Since all the individuals had not been diagnosed with depression, it is not clear if the BDI-II measured levels of depression or if it was measuring symptoms of general distress.

Bottom Line: In this study, 59% of the individuals were rated as having mild to severe levels of depression. These individuals were most likely to be older females with a mild traumatic brain injury who were taking anti-depressant medication. The results of this study cannot be generalized to all people with traumatic brain injuries because of the group’s characteristics and the small amount of individuals studied. The researchers state that further large research studies and identification of the best tools for measuring depression are needed to address the long-term emotional needs of individuals with traumatic brain injuries.

Find This Study:
Glenn, M.B., O’Neil-Pirozzi, T., Goldstein, R., Burke, D., & Jacob, L. (2001). Depression amongst outpatients with traumatic brain injury. Brain Injury, (15), 811-818.

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