Predicting depression following mild traumatic brain injury.
BACKGROUND
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.


METHODS
Prediction model using receiver operating characteristic curve.


METHODS
Level I trauma center in a major metropolitan area.


METHODS
Prospective cohort of 129 adults with mild traumatic brain injury.


METHODS
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.


CONCLUSIONS
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.
Levin
Harvey S
HS
Physical Medicine and Rehabilitation Alliance, Baylor College of Medicine, University of Texas-Houston Medical School, TX 77030, USA. hlevin@bcm.tmc.edu
McCauley
Stephen R
SR
Josic
Claudia Pedroza
CP
Boake
Corwin
C
Brown
Sharon A
SA
Goodman
Heather S
HS
Merritt
Shirley G
SG
Brundage
Susan I
SI
D000328:Adult; D000553:Ambulatory Care; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis*; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D015233:Models, Statistical; D011336:Probability; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D014193:Trauma Centers / Q000458:organization & administration; D015599:Trauma Severity Indices