Predicting depression following mild traumatic brain injury

Context: Minimizing negative consequences of major depression following traumatic brain injury is an important public health objective. Identifying high-risk patients and referring them for treatment could reduce morbidity and loss of productivity. Objective: To develop a model for early screening of patients at risk for major depressive episode at 3 months after traumatic brain injury. Design: Prediction model using receiver operating characteristic curve. Setting: Level I trauma center in a major metropolitan area. Participants: Prospective cohort of 129 adults with mild traumatic brain injury. Main Outcome Measures: Center for Epiderniologic Studies Depression Scale score and current major depressive episode module of the Structured Clinical Interview for the DSM-IV. Results: A prediction model including higher I-week Center for Epiderniologic Studies Depression Scale score, older age, and computed tomographic scans of intracranial lesions yielded 93% sensitivity and 62% specificity. Conclusion: This study supports the feasibility of identifying patients with mild traumatic brain injury who are at high risk for developing major depressive episode by 3 months' postinjury, which could facilitate selective referral for potential treatment and reduction of negative outcomes.