Depression in patients with traumatic brain injury - Prevalence and association with cognitive and physical function
- 21 Downloads
Depression is the most commonly diagnosed disorder among patients with traumatic brain injury (TBI). Understanding the association between the depression and the cognitive and physical function has important clinical implications in promoting the quality of life. Although evidences existed that patients with TBI experienced depression, cognitive impairment, and reduction in physical function. However, the relationship among these three conditions was not well understood. In the current study, we used the Hamilton Depression Scale, Montreal Cognitive Assessment-Basic Scale, and Activity of Daily Living Scale to assess the conditions of depression, cognition, and activities of daily living (ADL) among 145 TBI patients. To better understand the relationship between depression, cognition, and ADL, the data was analyzed using binary logistic regression. The Odds Ratio (OR) was computed to explore the risk of cognitive impairment and low-activities of daily living with depression. A total of 62.9% (n = 90/145) of patients lived with depression. The risk of cognitive impairment was 2.30 times higher for patients with depression than patients without depression (OR = 2.30, 95% confidence interval [CI] 1.08, 4.90), and the risk of low-activities of daily living was 5.14 times higher for patients with depression than patients without depression (OR = 5.14, 95% CI 2.17, 12.14). Compared to patients without depression, patients with depression scored worse on tests of language and visual-spatial perception, and were slower on tests of executive functioning. In summary, this study provides initial evidence that depression significantly affects the cognition and ADL of TBI patients.
KeywordsTraumatic brain injury Depression Cognition Activity of daily living
YL, LC and YW wrote the manuscript and performed the statistical analysis. QC, WL and QG revised the manuscript. All authors read and approved the final manuscript.
This paper is supported by the China Postdoctoral Science Foundation (2018 M632285), Zhejiang Natural Science Foundation (LY19H090015) and Postdoctoral Research Funding Program of Jiangsu Province(1701078C).
Compliance with Ethical Standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Institutional Review Board of Nanjing Medical University approved all the protocols. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
All authors declare that have no conflict of interest.
- Brailovskaia, J., Schönfeld, P., Kochetkov, Y., & Margraf, J. (2017). What does migration mean to us? USA and Russia: Relationship between migration, resilience, social support, happiness, life satisfaction, depression, anxiety and stress. Current Psychology, 1–11.Google Scholar
- Canham, R., Smith, S. L., & Tyrrell, A. M. (2000). Automated scoring of a neuropsychological test: The rey osterrieth complex figure. Paper presented at the Euromicro Conference, 2000. Proceedings of the 26th.Google Scholar
- Chen, K. L., Xu, Y., Chu, A. Q., Ding, D., Liang, X. N., Nasreddine, Z. S., . . . Guo, Q. H. (2016). Validation of the Chinese version of Montreal cognitive assessment basic for screening mild cognitive impairment. Journal of the American Geriatrics Society, 64(12), e285-e290. https://doi.org/10.1111/jgs.14530.CrossRefGoogle Scholar
- Duclos, C., Beauregard, M. P., Bottari, C., Ouellet, M. C., & Gosselin, N. (2015). The impact of poor sleep on cognition and activities of daily living after traumatic brain injury: A review. Australian Occupational Therapy Journal, 62(1), 2–12. https://doi.org/10.1111/1440-1630.12164.CrossRefGoogle Scholar
- Durish, C. L., Yeates, K. O., Stancin, T., Taylor, H. G., Walz, N. C., & Wade, S. L. (2018). Home environment as a predictor of long-term executive functioning following early childhood traumatic brain injury. Journal of the International Neuropsychological Society, 24(1), 11–21.CrossRefGoogle Scholar
- Failla, M. D., Juengst, S. B., Arenth, P. M., & Wagner, A. K. (2016a). Preliminary associations between brain-derived neurotrophic factor, memory impairment, functional cognition, and depressive symptoms following severe TBI. Neurorehabilitation and Neural Repair, 30(5), 419–430.CrossRefGoogle Scholar
- Garcia, S., Spitznagel, M. B., Cohen, R., Raz, N., Sweet, L., Colbert, L., . . . Gunstad, J. (2011). Depression is associated with cognitive dysfunction in older adults with heart failure. Cardiovascular Psychiatry and Neurology, 2011, 368324. https://doi.org/10.1155/2011/368324, 1, 6.CrossRefGoogle Scholar
- Hurst, F. G., Ownsworth, T., Beadle, E., Shum, D. H., & Fleming, J. (2018). Domain-specific deficits in self-awareness and relationship to psychosocial outcomes after severe traumatic brain injury. Disability and Rehabilitation, 1–9.Google Scholar
- Julayanont, P., Tangwongchai, S., Hemrungrojn, S., Tunvirachaisakul, C., Phanthumchinda, K., Hongsawat, J., . . . Nasreddine, Z. S. (2015). The Montreal cognitive assessment-basic: A screening tool for mild cognitive impairment in illiterate and low-educated elderly adults. Journal of the American Geriatrics Society, 63(12), 2550–2554. https://doi.org/10.1111/jgs.13820.CrossRefGoogle Scholar
- Kaplan, E., Goodglass, H., & Weintraub, S. (2001). Boston naming test: Pro-ed.Google Scholar
- Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9(3_Part_1), 179–186.Google Scholar
- Lingsma, H. F., Yue, J. K., Maas, A. I., Steyerberg, E. W., Manley, G. T., including, T.-T. I., . . . Menon, D. K. (2015). Outcome prediction after mild and complicated mild traumatic brain injury: External validation of existing models and identification of new predictors using the TRACK-TBI pilot study. Journal of Neurotrauma, 32(2), 83–94.Google Scholar
- Mayberg, H. S. (2002). Modulating limbic-cortical circuits in depression: Targets of antidepressant treatments. Paper presented at the Seminars in clinical neuropsychiatry.Google Scholar
- Osborn, A. J., Mathias, J. L., & Fairweather-Schmidt, A. K. (2014). Depression following adult, non-penetrating traumatic brain injury: A meta-analysis examining methodological variables and sample characteristics. Neuroscience and Biobehavioral Reviews, 47, 1–15. https://doi.org/10.1016/j.neubiorev.2014.07.007.CrossRefGoogle Scholar
- Schmidt, M. (1996). Rey auditory verbal learning test: A handbook. Los Angeles: Western psychological services.Google Scholar
- Shirai, M., Soshi, T., & Suzuki, N. (2018). Knowledge of sadness: Emotion-related behavioral words differently encode loss and failure sadness. Current Psychology, 1–15.Google Scholar
- Wada, T., Ishine, M., Sakagami, T., Okumiya, K., Fujisawa, M., Murakami, S., . . . Matsubayashi, K. (2004). Depression in Japanese community-dwelling elderly--prevalence and association with ADL and QOL. Archives of Gerontology and Geriatrics, 39(1), 15–23. https://doi.org/10.1016/j.archger.2003.12.003.CrossRefGoogle Scholar