Predicting depression following mild traumatic brain injury.

Arch Gen Psychiatry. 2006 May;62(5):523-8.

Levin HS, McCauley SR, Josic CP, Boake C, Brown SA, Goodman HS, Merritt SG, Brundage SI.

Physical Medicine and Rehabilitation Alliance, Baylor College of Medicine, University of Texas-Houston Medical School, TX 77030, USA.

CONTEXT: 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.

DESIGN: Prediction model using receiver operating characteristic curve.

SETTING: Level I trauma center in a major metropolitan area.

PARTICIPANTS: Prospective cohort of 129 adults with mild traumatic brain injury.

MAIN OUTCOME MEASURES: 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.

CONCLUSION: 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.