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Commentary |

Longitudinal Course of Mood Disorders Following Traumatic Brain Injury

Robert G. Robinson, MD; Ricardo Jorge, MD
Arch Gen Psychiatry. 2002;59(1):23-24. doi:10.1001/archpsyc.59.1.23.
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THIS STUDY raises the interesting but infrequently examined question about the longitudinal course of mood disorders associated with brain injury. The authors found that the lifetime prevalence of major depression in men who had suffered a head injury during the World War II was 18.5% vs 13.4% for a comparable group without head injury.

One might question the ability of veterans to accurately remember prior episodes of depressive disorder. For example, in one of our longitudinal studies of patients with stroke, we tried to assess the longitudinal course of depressive disorder throughout 10 years following the onset of stroke. Since we had accurate prospective examinations of depressive disorders during the first 2 years following stroke, we were able to assess patients and close relatives' ability to accurately recall their depressive disorder. Based on their no better than chance recollection of depression during the time that we had clear documentation, we concluded that the recall error of subsequent years was no more accurate than that of the first 2 years, and therefore could not be trusted. The findings in the current study, however, documented an increased rate in depression at the time of examination. Furthermore, poor recall of depressive symptoms would not be predicted to be worse in patients with head injury compared with controls. One must therefore conclude that the finding of an increased frequency of depression many years following head injury is a true phenomenon.

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