Risk of Depression after Traumatic Brain Injury in a Large National Sample

Jennifer S. Albrecht, Lauren Barbour, Samuel A. Abariga, Vani A Rao, Eleanor M. Perfetto

Research output: Contribution to journalArticle

Abstract

Depression is associated with poorer recovery after traumatic brain injury (TBI), yet awareness of depression risk post-TBI among providers and patients is low. The aim of this study was to estimate risk of depression post-TBI among adults 18 years of age and older and to identify risk factors associated with developing depression post-TBI. We conducted a retrospective, matched cohort study using claims data for privately insured and Medicare Advantage enrollees in a large U.S. health plan. Adults ≥18 years of age diagnosed with TBI (n = 207,354) with 12 months continuous insurance coverage pre-TBI and 24 months post-TBI were matched to controls without TBI (n = 414,708). We identified the presence of depression on any in-or outpatient claim occurring during the study period (both before and after TBI). Of the initial 622,062 individuals, 62,963 (10%) had depression pre-TBI and were excluded from incidence calculations. Incidence of depression post-TBI was 79.5 (95% confidence interval [CI], 78.5,80.5) per 1,000 person-years compared to 33.5 (95% CI, 33.1,34.0) per 1,000 person-years for those without TBI. The adjusted hazard ratio for depression post-TBI was 1.83 (95% CI, 1.79,1.86). We observed effect modification by sex and age, with males and older adults at increased risk. History of neuropsychiatric disturbances pre-TBI was the strongest predictor of depression post-TBI. Risk of depression increases substantially post-TBI. Groups at increased risk include those with a history of neuropsychiatric disturbances, older adults, and men. This study highlights the importance of long-Term monitoring for depression post-TBI.

Original languageEnglish (US)
Pages (from-to)300-307
Number of pages8
JournalJournal of Neurotrauma
Volume36
Issue number2
DOIs
StatePublished - Jan 15 2019

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Traumatic Brain Injury
Confidence Intervals
Medicare Part C
Insurance Coverage
Incidence
Cohort Studies
Outpatients
Health

Keywords

  • depression
  • epidemiology
  • traumatic brain injury

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Risk of Depression after Traumatic Brain Injury in a Large National Sample. / Albrecht, Jennifer S.; Barbour, Lauren; Abariga, Samuel A.; Rao, Vani A; Perfetto, Eleanor M.

In: Journal of Neurotrauma, Vol. 36, No. 2, 15.01.2019, p. 300-307.

Research output: Contribution to journalArticle

Albrecht, Jennifer S. ; Barbour, Lauren ; Abariga, Samuel A. ; Rao, Vani A ; Perfetto, Eleanor M. / Risk of Depression after Traumatic Brain Injury in a Large National Sample. In: Journal of Neurotrauma. 2019 ; Vol. 36, No. 2. pp. 300-307.
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