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Cited by 95Traumatic Brain Injury ResearchTraumatic Brain Injury and Neurovascular DisturbancesPosttraumatic Stress Disorder Research

Depression trajectories during the first year after traumatic brain injury

Open access
Bombardier, Charles H., Hoekstra, Trynke, Dikmen, Sureyya, Fann, Jesse R.·2016·Journal of Neurotrauma
DOI 10.1089/neu.2015.4349PMC PMC5124751
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Abstract

Major depression is prevalent after traumatic brain injury (TBI) and associated with poor outcomes. Little is known about the course of depression after TBI. Participants were 559 consecutively admitted patients with mild to severe TBI recruited from inpatient units at Harborview Medical Center, a Level I trauma center in Seattle, WA. Participants were assessed with the Patient Health Questionnaire-9 (PHQ-9) depression measure at months 1-6, 8, 10, and 12 post-injury. We used linear latent class growth mixture modeling (LCGMM) of PHQ-9 total scores to identify homogeneous subgroups with distinct longitudinal trajectories. A four-class LCGMM had good fit indices and clinical interpretability. Trajectory groups were: low depression (70.1%), delayed depression (13.2%), depression recovery (10.4%), and persistent depression (6.3%). Multinomial logistic regression analyses were used to distinguish trajectory classes based on baseline demographic, psychiatric history, and clinical variables. Relative to the low depression group, the other three groups were consistently more likely to have a pre-injury history of other mental health disorders or major depressive disorder, a positive toxicology screen for cocaine or amphetamines at the time of injury, and a history of alcohol dependence. They were less likely to be on Medicare versus commercial insurance. Trajectories based on LCGMM are an empirical and clinically meaningful way to characterize distinct courses of depression after TBI. When combined with baseline predictors, this line of research may improve our ability to predict prognosis and target groups who may benefit from treatment or secondary prevention efforts (e.g., proactive telephone counseling).

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  • Growth mixture modeling has been useful for recognizing classes of patients who share similar longitudinal trajectories of depressive symptoms.

    “recognizing classes of patients who share similar longitudinal trajectories of depressive symptoms (Bombardier et al., 2016; Gomez et al., 2017; Saunders et al., 2019; Saunders et al., 2020).”

    From Time in treatment: Examining mental illness trajectories across inpatient psychiatric treatment (2020) · cites this paper as Bombardier et al., 2016

  • Prior studies reported a trajectory showing gradual reemergence of depressive symptoms which may associate with a history of alcohol dependence and other mental illness disorders.

    “these prior studies also reported a trajectory showing gradual reemergence of depressive symptoms which may associate with a history of alcohol dependence and other mental illness disorders (Bombardier et al., 2016).”

    From Time in treatment: Examining mental illness trajectories across inpatient psychiatric treatment (2020) · cites this paper as Bombardier et al., 2016

  • The results are consistent with other studies demonstrating follow-up assessments of depressive symptoms after hospitalization for traumatic brain injury and maternal depressive symptoms from pregnancy through 2 years postpartum.

    “Our results are consistent with other studies demonstrating the follow-up assessments of depressive symptoms after hospitalization for traumatic brain injury (Bombardier et al., 2016) and maternal depressive symptoms from pregnancy through 2 years postpartum (Mora et al., 2008).”

    From Time in treatment: Examining mental illness trajectories across inpatient psychiatric treatment (2020) · cites this paper as Bombardier et al., 2016

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Authors
Bombardier, C. H., Hoekstra, T., Dikmen, S., & Fann, J. R.
Affiliations
  • University of Washington (US)
  • Amsterdam Public Health (NL)
Corresponding author
Bombardier, Charles H.
ORCID
Venue
Journal of Neurotrauma
Publisher
SAGE Publications
Published
2016-12
Volume
33
Issue
23
Pages
2115-2124
ISSN
  • 0897-7151 (ISSN-L)
  • 1557-9042
DOI
10.1089/neu.2015.4349
PMC
PMC5124751
OpenAlex
W2383055358
Cited by
95
References
73
Citations by year
2026: 11 · 2025: 10 · 2024: 7 · 2023: 7 · 2022: 11 · 2021: 10 · 2020: 12 · 2019: 10 · 2018: 7 · 2017: 8 · 2016: 2
FWCI
8.44
Type
journal article
Language
en
Open access
Licence
www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations
  • Journal of Neurotrauma (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • VU Research Portal (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • Pfizer
  • National Institutes of Health
  • National Institute of Child Health and Human Development
  • National Center for Medical Rehabilitation Research
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
traumatic brain injury, major depressive disorder, depression trajectories, PHQ-9, dysthymia, recovery from depression, alcoholism, psychiatric comorbidity, insurance type, prognosis
MeSH terms
Brain Injuries, Traumatic, Patient Health Questionnaire, Adolescent, Adult, Major Depressive Disorder, Depressive Disorder, Major, Female, Follow-Up Studies, Humans, Interview, Psychological, Male, Middle Aged, Time Factors, Young Adult

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