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Depression Following Traumatic Brain Injury: Epidemiology, Risk Factors and Management
Abstract
It is important for clinicians to recognize major depression following traumatic brain injury (TBI) because of its association with poor global and psychosocial outcome, postconcussive symptoms and cognitive deficits. The purpose of this review is to provide an up-to-date selective review of the current understanding of epidemiology, risk factors and management of major depression following TBI. Many studies of prevalence of depression following TBI have not used accepted structured criteria for the diagnoses, but those that did found wide ranges of rates, from 17% to 61%. The risk factors for development of depression following TBI are poorly understood, but past psychiatric history, frontal lesions and atrophy, and family dysfunction have been shown in more than one study to play important roles. There are few controlled trials of the treatment of major depression in patients with TBI using accepted diagnostic criteria for major depression, as well as defined criteria for response and remission. As such, it is important for clinicians to use best practice guidelines for the treatment of major depression in the absence of TBI.
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“Although treating these symptoms remains a challenge, evidence suggests that Acceptance and Commitment Therapy (ACT) can be an effective treatment for ABI-related anxiety and depressive symptoms (10–13).”
From Trial-based economic evaluation of the BrainACT study: acceptance and commitment therapy for anxiety and/or depressive symptoms after acquired brain injury. (2025) · cites this paper as [10]
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“Even after controlling for medical, demographic, and neuropsychological factors, studies have found that depression following TBI is associated with global outcomes [17], a negative impact on social functioning [18], and lower healthrelated quality of life [19].”
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“Rapoport 2012 found three studies investigating physical exercise interventions (including Hoffman 2010 identified in the current review), and three pertaining to CBT. Rapoport 2012 concluded that the evidence regarding interventions was inconclusive, and although CBT and exercise interventions…”
BackgroundInfluentialAnxiety and Posttraumatic Stress Disorder Among Medicare Beneficiaries After Traumatic Brain Injury
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Bauer, I. E., & Meyer, T. D. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108623018.021 · Cited by 2
Single-Item Screening for Depression in Adults (50+) with History of Traumatic Brain Injury
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Brenner, L. A., Hoffberg, A. S., Shura, R. D., Bahraini, N. H., & Wortzel, H. S. (2013) · Current Physical Medicine and Rehabilitation Reports · doi:10.1007/s40141-013-0022-1 · Cited by 2
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Ramakrishnan, N., Murphy, N., Selvaraj, S., & Cho, R. Y. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108623018.015 · Cited by 2
Eliasen, M., Petersen, J., Benros, M. E., & Osler, M. (2021) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13347 · Cited by 3
Clay, F. J., Perry, L. A., Hicks, A. J., Batty, R. A., Tufănaru, C., Jayaram, M., Ponsford, J. L., & Hopwood, M. (2017) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2016-003326 · Cited by 1
Treatment of Depression Following a Traumatic Brain Injury
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“Recent research suggests higher incidents/prevalence of depression after traumatic brain injury (TBI; Jorge & Starkstein, 2005; Kreutzer, Seel, & Gourley, 2001; Rapoport, 2012).”
BackgroundDepression After Traumatic Brain Injury
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“…risk of depression, anxiety, and poor functional recovery after stroke as well as traumatic brain injury, suggesting a shared genetic or psychosocial vulnerability (Tenev et al., 2009; Cheng et al., 2024; Rapoport, 2012; Torregrossa et al., 2023; Hackett et al., 2014; Stangeland et al., 2018b).”
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Neuropsychiatric and behavioral sequelae
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Paiva, W. S., & Paulo, S. (2016)
Persistent Post-Concussive Psychiatric Problems
Victoroff, J. (2019) · Cambridge University Press eBooks · doi:10.1017/9781139696432.012
Metadata
- Authors
- Rapoport, M. J.
- Affiliations
- Sunnybrook Health Science Centre (CA)
- Corresponding author
- Rapoport, Mark J.
- ORCID
- Rapoport, Mark J.
- Venue
- CNS Drugs
- Published
- 2012-02
- Volume
- 26
- Issue
- 2
- Pages
- 111-121
- ISSN
- 1172-7047 (ISSN-L)
- OpenAlex
- W2035993893
- Cited by
- 125
- References
- 76
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 3 · 2023: 4 · 2022: 5 · 2021: 30 · 2020: 3 · 2019: 8 · 2018: 10 · 2017: 9 · 2016: 6 · 2015: 13 · 2014: 14 · 2013: 11
- FWCI
- 9.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CNS Drugs (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- major depressive disorder, traumatic brain injury, post-traumatic depression, depression prevalence, risk factors, frontal lobe lesions, brain atrophy, family dysfunction, post-concussion symptoms, cognitive impairment, depression treatment, psychosocial outcomes
- MeSH terms
- Brain Injuries, Depressive Disorder, Humans, Psychiatric Status Rating Scales, Risk Factors, Disease Management
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