Major and Minor Depression After Traumatic Brain Injury
Major and Minor Depression After Traumatic Brain Injury
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DOI：
10.1016/j.apmr.2011.03.005
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发表时间：
2011-08-01
影响因子：
4.3
通讯作者：
Arango-Lasprilla, Juan Carlos
中科院分区：
文献类型：
--
作者：
Hart, Tessa;Brenner, Lisa;Arango-Lasprilla, Juan Carlos
哈特T，布伦纳L，克拉克AN，博格纳JA，诺瓦克TA，Chervoneva I，Nakase-Richardson R，Arango-Lasprilla JC.创伤性脑损伤后的重度和轻度抑郁。Arch Phys Med Rehabil 2011;92：1211- 9.目的：检查创伤性脑损伤（TB！）后1年的轻度和重度抑郁症，特别关注抑郁严重程度对社会参与水平的贡献。设计：观察性前瞻性研究，2波纵向分量。设置：住院康复中心，主要通过电话进行1年随访。参与者：TBI患者（N=1570）登记在TBI模型系统数据库中，并在伤后1年随访。干预措施：不适用。主要结果测量：结果：22%的样本报告轻度抑郁，26%的样本报告重度抑郁，TBI后1年。这两种程度的抑郁与性别（女性）、年龄（年轻）、伤前心理健康治疗和药物滥用以及受伤原因（故意）有关。抑郁症的严重程度和所有1年的研究结果之间存在单调的剂量反应关系，包括认知和身体残疾水平，总体结果和生活满意度。与其他预测控制，抑郁症的严重程度仍然显着相关的社会参与水平在1年后TBI.Conclusions：轻度抑郁症可能是常见的严重抑郁症TBI后，应认真对待其关联的负面结果相关的参与和生活质量。研究结果表明，在其他人群中，轻度和重度抑郁症不是独立的实体，而是存在于一个连续体上。进一步的研究应该确定TBI患者是否像其他患者组一样在2种诊断之间来回移动。
Hart T, Brenner L, Clark AN, Bogner JA, Novack TA, Chervoneva I, Nakase-Richardson R, Arango-Lasprilla JC. Major and minor depression after traumatic brain injury. Arch Phys Med Rehabil 2011;92:1211-9.Objective: To examine minor as well as major depression at 1 year posttraumatic brain injury (TB!), with particular attention to the contribution of depression severity to levels of societal participation.Design: Observational prospective study with a 2-wave longitudinal component.Setting: Inpatient rehabilitation centers, with 1-year follow up conducted primarily by telephone.Participants: Persons with TBI (N=1570) enrolled in the TBI Model System database and followed up at I-year postinjury.Interventions: Not applicable.Main Outcome Measures: FIM, Patient Health Questionnaire-9, Participation Assessment with Recombined Tools-Objective, Glasgow Outcome Scale-Extended, and the Satisfaction With Life Scale.Results: Twenty-two percent of the sample reported minor depression, and 26% reported major depression at 1-year post-TBI. Both levels of depression were associated with sex (women), age (younger), preinjury mental health treatment and substance abuse, and cause of injury (intentional). There was a monotonic dose-response relationship between severity of depression and all 1-year outcomes studied, including level of cognitive and physical disability, global outcome, and satisfaction with life. With other predictors controlled, depression severity remained significantly associated with the level of societal participation at 1-year post-TBI.Conclusions: Minor depression may be as common as major depression after TBI and should be taken seriously for its association to negative outcomes related to participation and quality of life. Findings suggest that, as in other populations, minor and major depression are not separate entities, but exist on a continuum. Further research should determine whether people with TBI traverse between the 2 diagnoses as in other patient groups.