Volume 40 · Number 11
NOVEMBER 2010
Depression Complicating Traumatic Brain Injury: The Path to a Poor Prognosis
Psychiatr Ann. 2010 November;40(11):581-587
By Mark Rapoport, MD, FRCPC
Major depression is likely the most common psychiatric complication of traumatic brain injury (TBI). Evidence is accumulating for its association with a poor outcome characterized by increased disability, psychosocial distress, postconcussive symptoms, and cognitive deficits. Clinical guidelines have provided direction for the treatment of major depression after TBI, but the evidence of benefits in the literature is somewhat equivocal. This article is a selective review of the importance of assessing for depressive symptoms after TBI, the current understanding of pathophysiology, and the association of depression with a particularly poor prognosis. Finally, the evidence pertaining to treatment of major depression following TBI will be discussed, highlighting the frustratingly poor response to treatment.
ABOUT THE AUTHOR
Mark Rapoport, MD, FRCPC, is Clinical Psychiatrist, Sunnybrook Health Sciences Centre, Geriatric Traumatic Brain Injury Clinic; and Associate Professor, Department of Psychiatry, University of Toronto.
Address correspondence to: Mark Rapoport, MD, FRCPC, FG37-2075 Bayview Avenue, Toronto, ON M4N 3M5; or e-mail: [email protected].
Dr. Rapoport has disclosed the following relevant financial relationships: Canadian Academy of Geriatric Psychiatry-Eli Lilly Fellowship and Sunnybrook Trust Fund: Fellowship funding recipient; Janssen-Ortho: Member of advisory board; Alzheimer’s Society of St. Thomas, Alzheimer’s Society of Toronto, Janssen-Ortho, and Novartis: Member of speakers’ bureau; Alzheimer’s Society of Canada, Canadian Institute of Health Research, Ontario Neurotrauma Foundation, and Physician’s Services Inc. Foundation: Research grant recipient.
The author would like to thank Dr. Krista Lanctot for her scholarly comments on the manuscript.
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