Predicting depression following mild traumatic brain injury

Arch Gen Psychiatry. 2005 May;62(5):523-8. doi: 10.1001/archpsyc.62.5.523.


Context: Minimizing negative consequences of major depression following traumatic brain injury is an important public health objective. Identifying high-risk patients and referring them for treatment could reduce morbidity and loss of productivity.

Objective: To develop a model for early screening of patients at risk for major depressive episode at 3 months after traumatic brain injury.

Design: Prediction model using receiver operating characteristic curve.

Setting: Level I trauma center in a major metropolitan area.

Participants: Prospective cohort of 129 adults with mild traumatic brain injury.

Main outcome measures: Center for Epidemiologic Studies Depression Scale score and current major depressive episode module of the Structured Clinical Interview for the DSM-IV.

Results: A prediction model including higher 1-week Center for Epidemiologic Studies Depression Scale score, older age, and computed tomographic scans of intracranial lesions yielded 93% sensitivity and 62% specificity.

Conclusion: This study supports the feasibility of identifying patients with mild traumatic brain injury who are at high risk for developing major depressive episode by 3 months' postinjury, which could facilitate selective referral for potential treatment and reduction of negative outcomes.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Ambulatory Care
  • Brain Injuries / complications
  • Brain Injuries / diagnosis*
  • Cohort Studies
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / etiology
  • Depressive Disorder, Major / prevention & control
  • Diagnostic and Statistical Manual of Mental Disorders
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Mass Screening / methods
  • Models, Statistical
  • Probability
  • Prospective Studies
  • Psychiatric Status Rating Scales / statistics & numerical data
  • ROC Curve
  • Risk Factors
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / statistics & numerical data
  • Trauma Centers / organization & administration
  • Trauma Severity Indices