title: The efficacy of a scheduled telephone intervention for ameliorating depressive symptoms during the first year after traumatic brain injury.
abstract: OBJECTIVE
  To determine whether an intervention designed to improve functioning after traumatic brain injury (TBI) also ameliorates depressive symptoms.
  
  
  METHODS
  Single-blinded, randomized controlled trial comparing a scheduled telephone intervention to usual care.
  
  
  METHODS
  One hundred seventy-one persons with TBI discharged from an inpatient rehabilitation unit.
  
  
  METHODS
  The treatment group received up to 7 scheduled telephone sessions over 9 months designed to elicit current concerns, provide information, and facilitate problem solving in domains relevant to TBI recovery.
  
  
  METHODS
  Brief Symptom Inventory-Depression (BSI-D) subscale, Neurobehavioral Functioning Inventory-Depression subscale, and Mental Health Index-5 from the Short-Form-36 Health Survey.
  
  
  RESULTS
  Baseline BSI-D subscale and outcome data were available on 126 (74%) participants. Randomization was effective except for greater severity of depressive symptoms in the usual care (control) group at baseline. Outcome analyses were adjusted for these differences. Overall, control participants developed greater depressive symptom severity from baseline to 1 year than did the treatment group. The treated group reported significantly lower depression symptom severity on all outcome measures. For those more depressed at baseline, the treated group demonstrated greater improvement in symptoms than did the controls.
  
  
  CONCLUSIONS
  Telephone-based interventions using problem-solving and behavioral activation approaches may be effective in ameliorating depressive symptoms following TBI. Proactive telephone calls, motivational interviewing, and including significant others in the intervention may have contributed to its effectiveness.
authors.affiliation: Departments of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, USA. chb@u.washington.edu
authors.forename: Charles H
authors.initials: CH
authors.lastname: Bombardier
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Bell
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Temkin
authors.forename: Jesse R
authors.initials: JR
authors.lastname: Fann
authors.forename: Jeanne
authors.initials: J
authors.lastname: Hoffman
authors.forename: Sureyya
authors.initials: S
authors.lastname: Dikmen
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000523:psychology*; D003376:Counseling; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013689:Telephone