Co-existence of depression and post-concussion syndrome one month after mild traumatic brain injury

ABSTRACT

Background

Previous studies suggest an association between Post-concussion syndrome (PCS) and depression, both highly prevalent after mTBI.

Objective

To assess the prevalence and risk-factors of depression among patients with PCS 1 month after mTBI.

Methods

We prospectively screened 372 mTBI patients admitted in two academic Emergency Departments between 2017 and 2019. One month after mTBI, we administered the Rivermead Post-concussion symptoms Questionnaire (RPQ) and the Patient Health Questionnaire (PHQ-9) questionnaires over the telephone. PCS and depression were defined by RPQ ≥ 12 and PHQ-9 ≥ 10. Multivariate multinomial regression identified baseline factors associated with PCS and depression.

Results

Two hundred and eight completed RPQ and PHQ-9. Forty-seven patients (22.5%) met criteria for PCS, among which 22 (46.8%) met criteria for depression (PCS+D+). Patients with PCS but without depression were less likely to present with an associated injury (Coefficient = −1.6, p = 0.047) and to report initial sadness (Coefficient = −2.5, p = 0.03). Initial sadness (Coefficient = −1.3, p = 0.047), associated injury (Coefficient = −1.9, p = 0.008), as well as initial nausea (Coefficient = −1.8, p = 0.002), and male sex (Coefficient = 1.8, p = 0.002), were associated with the absence of depression and PCS in comparison with PCS+D+ patients.

Conclusion

Among patients with PCS 1 month after mTBI, those with depression are more likely to present with initial sadness and with an associated injury.

KEYWORDS:

• mTBI
• post-concussion syndrome
• depression
• Rivermead
• PHQ-9

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authorship confirmation statement

PD, PA, and PVA supervised the conduct of the trial and data collection. PD, PVA, CL, MC, TF, and MGS undertook recruitment of participating centers and patients and managed the data, including quality control. AD provided statistical advice on study design and analyzed the data; AB, PVA, and MF drafted the manuscript, and all authors contributed substantially to its revision. PD takes responsibility for the paper as a whole.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02699052.2024.2311338.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.