Wednesday, February 15, 2017

Meta-Analysis Reveals Several Predictors of MDD, PTSD Following TBI

A history of pre-injury depression and shorter period of amnesia following injury are just two of several factors that may predict whether a person with traumatic brain injury (TBI) is likely to later develop major depressive disorder (MDD) or posttraumatic stress disorder (PTSD), according to a meta-analysis published Tuesday in The Journal of Neuropsychiatry and Clinical Neurosciences.

“This knowledge could be used to flag patients who might benefit from additional monitoring or (preventive) therapeutic interventions, which have shown to be effective in people at risk for MDD and PTSD,” Suzanne Polinder, Ph.D., of Erasmus Medical Center in The Netherlands and colleagues wrote.

Polinder and colleagues systematically reviewed the literature on predictors and multivariable models for MDD and PTSD after TBI. A total of 26 observational studies were found. Participants in the studies were civilian adults at least 16 years of age who sustained TBI.

The researchers found that MDD following TBI was associated with female gender, preinjury depression, post-injury unemployment, and lower brain volume. Individuals who experienced PTSD following TBI were more likely to have shorter periods of posttraumatic amnesia and memory of the traumatic event. They were also more likely to have early posttraumatic symptoms.

The researchers noted that some of the studies included in the analysis had methodological problems and more research is needed to confirm the predictors of MDD and PTSD after TBI. “The results of this systematic review imply that there is still limited knowledge regarding which patients develop MDD and PTSD after TBI,” they wrote.

“Physicians could be extra aware regarding female patients with a preinjury history of depression and postinjury unemployment or psychiatric symptoms. Also, a reduction in brain volume might indicate a risk of developing MDD postinjury. Furthermore, patients with a shorter [amnesia after the trauma], with a clear memory of the traumatic event, and with early posttraumatic symptoms might be at higher risk of developing PTSD post-TBI,” they concluded.

For related information, see the Psychiatric News article “Sertraline May Help Prevent Depression Following Traumatic Brain Injury.”

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