Depression treatment preferences after traumatic brain injury

J Head Trauma Rehabil. Jul-Aug 2009;24(4):272-8. doi: 10.1097/HTR.0b013e3181a66342.

Abstract

Objective: To determine preferences for depression treatment modalities and settings among persons with traumatic brain injury (TBI).

Design: Telephone survey. Depression status was determined using the Patient Health Questionnaire-9.

Setting: Harborview Medical Center, Seattle, Washington, the level I trauma center serving Washington, Idaho, Montana, and Alaska.

Participants: One hundred forty-five adults, English-speaking consecutive patients admitted with complicated mild to severe TBI.

Main outcome measures: Telephone survey within 12 months post-TBI ascertaining preferences for depression treatment modalities and settings.

Results: More patients favored physical exercise or counseling as a depression treatment than other treatment modalities. Group therapy was the least favored modality. Patients favored speaking with a clinician in the clinic or over the telephone and were less likely to communicate with a clinician over the Internet. Subjects with probable major depression or a history of antidepressant use or outpatient mental health treatment were more likely to express a preference for antidepressants for treatment of depression.

Conclusions: This study underscores the importance of understanding patient preferences and providing patient education in selecting a treatment for depression after TBI. Future studies should examine psychotherapy and alternative treatment modalities and delivery models for the management of depression in this vulnerable population.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use
  • Attitude to Health
  • Brain Injuries / psychology*
  • Choice Behavior
  • Complementary Therapies
  • Counseling
  • Depression / psychology
  • Depression / therapy*
  • Exercise
  • Female
  • Group Processes
  • Humans
  • Internet
  • Interviews as Topic
  • Male
  • Patient Satisfaction*
  • Psychotherapy
  • Severity of Illness Index

Substances

  • Antidepressive Agents