1. Study of depression and associated factors in traumatic brain injury Anand sharma, Prof. R. S. Mittal, Achal Sharma, Akhilesh jain , I.D.Gupta
Depression
No Depression
Introduction
Incidence 1,444,000 patient had TBI per year
80% are mild to moderate head injury
Post TBI patients had emotional, behavioral, physical, and psychosocial problems
Aim And objective
To investigate the prevalence and determinants of depression and its correlation with quality of life in patients of TBI.
Material and method
Inclusion criteria –Patients with mild to moderate TBI those who can be able to comprehend or answer verbal or written questionnaires. Exclusion criteria- to have a serious medical illness, to have a history of current or past psychosis or mania or any other mental disorder except MDD using DSM-IV criteria
Tools Used- PHQ 9 and QOL BREF WHO for assessment of depression and QOL.
Discussion
1.Strong association between head injury and depression corroborating findings of other studies (Creed F et al. 1990, Anderson KO et al. 2.Severity of head injury is associated with the severity of depression. 3. Strong association has been established between duration of head injury and occurrence of depression.4.Left frontal and left temporal contusions are high risk factor for occurrence of depression.
5.Quality of life is poor in traumatic brain injury patients. 6.Coexisting depression independently affect quality of life and outcome in traumatic brain injury
Conclusion
Depression are commonly associated, yet under diagnosed clinical entities in head injury and have tremendous impact in overall outcome measures. Every patient of head injury warrants psychiatric evaluation and concomitant treatment if required to ensure the attainment of not only neuroanatomical intact but overall productive and qualitative life vindicating the holistic and multidisciplinary treatment approach.
Figure 1 Showing Incidence of depression
Figure 2 Correlation of depression with duration of head injury
Figure 3 Prevalence of depression with type of injury
Brain area
Depression
Multiple lobe
53.3%
Left frontal
10%
Right temporal
6.7%
Left temporal
16.7%
Right sub cortical
3.3%
Left sub cortical
Figure 4 Distribution of contusions in depressed patients
QOL Domain
No Depression
Depression
Physical health
66.67
45.09
Psychosocial health
69.33
47.52
Social relationship
67.25
46.54
Environment
42.31
Figure 5 Quality of life in TBI Patients
Referances
1.Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: a brief overview. ead Trauma Rehabil. 2006;21(5):
2 NIH Consensus Development Panel on Rehabilitation of Persons With Traumatic Brain Injury.  Rehabilitation of persons with traumatic brain I injury.  JAMA. 1999;282(10):