title: Role of sertraline in posttraumatic brain injury depression and quality-of-life in TBI.
abstract: BACKGROUND
  Traumatic brain injury (TBI) is a major cause of disability. Depression is one of the major squeal of TBI in both in-patient and out-patient populations. Depression is associated with numerous negative outcomes, thus affecting quality-of-life (QOL) adversely in these patients. Addressing depression in treatment regimen of TBI may improve QOL of these patients.
  
  
  OBJECTIVE
  The present study is designed to evaluate the role of sertraline in post TBI depression and its impact on QOL.
  
  
  METHODS
  Eighty male patients with post TBI depression were included in the study among the 250 male patients of mild to moderate TBI recruited for the evaluation. Half of the patients were given sertraline 50 mg PO, whereas other half served as control without sertraline treatment. Participants were assessed on Glasgow Coma scale, Patient Health Questionnaire-9 (PHQ-9) and World Health Organization QOL (WHOQOL) at regular interval till the end of 6 months.
  
  
  RESULTS
  Depression was found in 35.6% of total patients recruited. Most of the patients (63.1%) were below 35 years of age. Depression was more common in mild TBI cases than those with moderate TBI (53.7% vs. 46.25%, P = 0.04). Left side brain injury (56.25%) with cerebral contusions was more commonly associated with depression (P = 0.04). Patients in sertraline group responded well to treatment with significant improvement in mod symptoms (PHQ-9 score 14.88 ± 3.603 vs. 5.33 ± 2.98, P = 0.04)). All the four domains of QOL improved significantly in sertraline group than the control group with sertraline treatment.
  
  
  CONCLUSIONS
  Management of TBI should also focus on treatment of associated mood symptoms, which is likely to be associated with poor QOL in these patients. Sertraline has been found to be effective in the treatment of depression with significant improvement in QOL in TBI patients.
authors: Department of Neurosurgery, S.M.S. Medical College, Jaipur, Rajasthan, India.
authors: Ahmed
authors: A
authors: Ansari
authors: Department of Psychiatry, ESIC Model Hospital, Jaipur, Rajasthan, India.
authors: Akhilesh
authors: A
authors: Jain
authors: Department of Neurosurgery, S.M.S. Medical College, Jaipur, Rajasthan, India.
authors: Achal
authors: A
authors: Sharma
authors: Department of Neurosurgery, S.M.S. Medical College, Jaipur, Rajasthan, India.
authors: R S
authors: RS
authors: Mittal
authors: Department of Psychiatry, S.M.S Medical College, Jaipur, Rajasthan, India.
authors: I D
authors: ID
authors: Gupta
keywords: Depression; quality of life; traumatic brain injury