Functional Limitations and Depression After Traumatic Brain Injury: Examination of the Temporal Relationship
Presented to the International Neuropsychological Society, February 2007, Portland, OR.
Abstract
Pagulayan KF, Hoffman JM, Temkin NR, Machamer JE, Dikmen SS. Functional limitations and depression after traumatic brain injury: examination of the temporal relationship.
Objective
To examine the temporal relationship between self-reported injury-related functional limitations and depressive symptomatology after traumatic brain injury (TBI).
Design
A longitudinal cohort study with 3 evaluation points.
Setting
A level I trauma center.
Participants
Adolescents and adults (N=135) with complicated mild to severe TBI (72% had complicated mild injuries) who were recruited within 24 hours of injury and then completed the measure at all 3 time points.
Interventions
Not applicable.
Main Outcome Measures
Sickness Impact Profile and Center for Epidemiological Studies−Depression Scale.
Results
Individuals who reported more depressive symptomatology consistently endorsed more injury-related difficulties, showing the strong relationship between depression and perceived psychosocial functioning. Examination of these relationships over time revealed that increased depressive symptomatology follows higher levels of perceived injury-related changes but that reports of injury-related changes are not associated with earlier depression. These findings suggest a unidirectional temporal relationship between these variables.
Conclusions
Perceived changes in daily functioning appear to influence emotional well-being over time after TBI. However, depressive symptoms do not appear to negatively impact individuals' perception of later functioning. These results further our understanding of the complicated relationship between these variables and may have important implications for treatment of depression after TBI.
aDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA
bDepartment of Neurological Surgery, University of Washington, Seattle, WA
cDepartment of Biostatistics, University of Washington, Seattle, WA
Correspondence to Kathleen Farrell Pagulayan, PhD, VA Puget Sound Health Care System, 1660 S Columbian Way, S-116 MHC, Seattle, WA 98108
Supported by the National Institute of Neurological Disorders and Stroke, National Institutes of Health (grant no. RO1 NS19643) and the National Center for Medical Rehabilitation Research, National Institutes of Health (grant no. F32 HD048030).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT