Research Reports - Traumatic brain injury and affective disorder

J Affect Disord. 2015 Nov 19;191:56-61. doi: 10.1016/j.jad.2015.11.035. [Epub
ahead of print]

Chi YC(1), Wu HL(2), Chu CP(3), Huang MC(4), Lee PC(5), Chen YY(6).

BACKGROUND: Studies investigating the relationship between head injury and the
subsequent onset of affective disorders often show conflicting results.
AIMS: To investigate the risk of affective disorders following traumatic brain
injury in a large Taiwanese cohort.
METHOD: This retrospective cohort study makes use of the National Health
Insurance Research Database. A cohort containing 68,376 individuals who
experienced traumatic brain injury (TBI) during 2000-2010 and had no prior
history of mental disorders before the injury was identified. Using Cox
Proportional Hazards regression, the subsequent risk of affective disorders was
determined.
RESULTS: TBI was associated with a higher risk of both bipolar disorder (Hazard
Ratio [HR]=1.42, 95% Confidence Interval [CI]=[1.26, 1.59]) and major depression
(HR=1.41, 95% CI=[1.28, 1.54]). More severe injury was associated with greater
risk. The first year following the injury was the highest risk period for major
depression, while the highest risk period for bipolar disorder was delayed until
two to four years following the injury.
LIMITATIONS: Using a claims database, we were unable to assess confounding
variables that were not contained in the data set.
CONCLUSIONS: The elevated risks of affective disorders after TBI speak to the
psychiatric need of individuals who suffer from brain injury. Early detection and
timely intervention may help prevent secondary and tertiary disability associated
with head trauma. 

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