title: Are there symptoms that are specific for depressed mood in patients with traumatic brain injury?
abstract: This study examined the specificity of vegetative and psychological symptoms of depression among 66 patients with acute traumatic brain injury followed over 1 year. The median frequencies of vegetative and psychological symptoms among patients with depressed mood were 3 and 3. These frequencies were three times the respective rates among nondepressed patients. Although change in self-attitude and subjective anergia distinguished depressed from nondepressed patients throughout the 1-year follow-up, some symptoms, such as early awakening and difficulty concentrating, distinguished groups only after 6 months. If diagnostic criteria for major depression were modified to include only specific symptoms of depression, the standard (i.e., unmodified) DSM-III-R still had a 100% sensitivity and 94% specificity at the initial evaluation and 80% and 100%, respectively, at 1 year. There were almost no patients with depressive symptoms without a depressed mood (i.e., "masked" depressions). These findings suggest that DSM-III-R criteria for major depression are useful, even in an acute head-injured population, but also suggest that the nature of posttraumatic brain injury depressive disorder may change over time.
authors.affiliation: Department of Psychiatry, University of Iowa College of Medicine, Iowa City 52242.
authors.forename: R E
authors.initials: RE
authors.lastname: Jorge
authors.forename: R G
authors.initials: RG
authors.lastname: Robinson
authors.forename: S
authors.initials: S
authors.lastname: Arndt
mesh_terms: D000208:Acute Disease; D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000523:psychology; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D012893:Sleep Wake Disorders / Q000175:diagnosis; D009626:Terminology as Topic