Short Tilte:Self-assessment of impairment, impaired self-awareness, and depression after traumatic brain injury
Journal:Journal of Head Trauma Rehabilitation
Year, Volume, Issue, Page(s):07, 22, 3, 156-66
Objective: To identify patient features associated with early and late depression after traumatic brain injury (TBI). Participants: 3 clinical trauma groups (mild TBI, moderate-severe TBI, orthopedic injury) and their significant others. Measures: Preinjury: age, education, substance abuse, and psychiatric history; Injury severity: classification using Glasgow Coma Scale and cranial CT scan, posttraumatic amnesia; Early impairment: Neurobehavioral Functioning Inventory (NFI), Impaired Self-Awareness (ISA); Social and family support:Multidimensional Scale of Perceived Social Support, Family Assessment Device; Depression: NFI Depression Scale. Method: Regression analyses of predictor
variables on early and late measures of depression. Results: Depression rates did not differ among the 3 trauma groups. Preinjury level of education, previous psychiatric history, and perceived level of social support explained a small portion of the variance in depressive symptoms. Patients’ self-assessment of their impairment at discharge was most strongly correlated with both early and late depression. ISA was associated with reduced self-report of depressive symptoms. However, when those with ISA were excluded from the analysis, self-assessment of impairment remained strongly associated with depression. Conclusions: Patients’ self-assessment of impairment is strongly associated with early and late depression. Presence and severity of TBI does not appear to play a direct role in depression but does appear related to ISA, which serves as a barrier to the development of depression. Focusing on impairment appears to be a cardinal feature of depression in both patients with TBI and an orthopedic trauma group.