New comparative effectiveness review released on traumatic brain injury and depression
Research Activities, June 2011, No. 370
The Agency for Healthcare Research and Quality (AHRQ) has released a new systematic review of 115 clinical studies involving depression after traumatic brain injury (TBI). Comparative Effectiveness Review of Traumatic Brain Injury and Depression, prepared by researchers at the AHRQ-funded Vanderbilt Evidence-based Practice Center, addresses key questions on depression after traumatic brain injury.
Key findings include:
- The prevalence of depression after a TBI was approximately 30 percent across multiple time points up to and beyond 1 year.
- Based on structured clinical interviews, on average 27 percent of individuals met criteria for depression 3 to 6 months after injury; 32 percent at 6 to 12 months; and 33 percent beyond 12 months. Higher prevalence estimates were reported in many study populations.
- Data are sparse to assess the relationship of severity, mechanism, or area of the brain injured to risk of depression.
- Few risk factors for depression have been studied across populations in models that adjust for confounding factors. Alcohol and substance abuse, coexisting illness or injury, degree of disability, and older age at injury may contribute to increased risk.
- The literature is insufficient to determine whether tools validated in other populations for detecting depression appropriately identify individuals with depression after a TBI.
Given the at least 1.5 million TBIs per year, with many potential consequences that impair quality of life and function, substantially greater efforts are warranted to understand the biologic causes, natural history, treatment, and prevention of depression after TBI. The information in this report, including the discussion of current research needs, may help inform research in this area.