title: Clinical and neuropsychological correlates of major depression following post-traumatic brain injury, a prospective study.
abstract: OBJECTIVE
  Major depression disorder (MDD) is the most frequent psychiatric complication after traumatic brain injury (TBI), with a prevalence of 14-77%. The aim of this study was to analyse the psychiatric sequelae of TBI, and to identify the neuropsychological and psychopathological correlates of post-TBI MDD in order to highlight their differences from those of primary MDD.
  
  
  METHODS
  This was a longitudinal, prospective, case-control study. Sixteen patients with closed brain injury, and a lesion revealed by computed tomography (CT), were recruited and were evaluated one (T1), three (T3) and six (T6) months after discharge from Neurosurgery Department; the controls were six patients with MDD. The psychiatric symptoms were evaluated using brief psychiatric rating scale (BPRS), Hamilton depression rating scale (HRSD), Beck depression inventory scale (BDI), Hamilton anxiety rating scale (HRSA), global assessment of functioning (GAF) and instrumental activity of daily living (IADL). Neuropsychological profiles were assessed by using neuropsychological tests, focused on memory and frontal-executive functioning.
  
  
  RESULTS
  At T1, MDD was observed in 10 cases (62.5%), a manic episode in 12.5%, and post-traumatic stress disorder in 6.5%. At T3 and T6, MDD was diagnosed in, respectively, eight (50%) and six cases (37.5%). Post TBI MDD had less severe depressive symptoms, showed greater social isolation and hostility and more cognitive deficits in comparison with the control group.
  
  
  CONCLUSIONS
  MDD is a frequent TBI complication. Patients with post-TBI MDD have a specific psychopathological profile characterised by a less severe depressive symptomatology and a neuropsychological pattern that is significantly associated with greater deficits in cognitive functions than those with primary MDD.
authors.affiliation: Clinical Psychiatry Neuropsychopharmacology Unit, IRCCS Foundation, Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: maurimc@policlinico.mi.it.
authors.forename: M C
authors.initials: MC
authors.lastname: Mauri
authors.affiliation: Clinical Psychiatry Neuropsychopharmacology Unit, IRCCS Foundation, Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Paletta
authors.affiliation: Neuropsychopharmacology Unit, Division of Experimental Medicine, Imperial College London, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Colasanti
authors.affiliation: Clinical Neurosurgery, IRCCS Foundation, Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Miserocchi
authors.affiliation: Clinical Psychiatry Neuropsychopharmacology Unit, IRCCS Foundation, Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: A C
authors.initials: AC
authors.lastname: Altamura
mesh_terms: D000328:Adult; D001288:Attention; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology; D016022:Case-Control Studies; D003071:Cognition; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Major depression disorder; Neuropsychological profile; Psychopathological pattern; Traumatic brain injury