Research Reports - Effects of depression and antidepressant use on cognitive deficits following severe traumatic brain injury

J Head Trauma Rehabil. 2016 Jan 29. [Epub ahead of print]

Failla MD(1), Juengst SB, Graham KM, Arenth PM, Wagner AK.

OBJECTIVE: To use a Rehabilomics framework to evaluate relations hips between
post-traumatic brain injury (TBI) depression (PTD) and potential associated
factors, including antidepressant use, on cognitive recovery following severe
TBI.
PARTICIPANTS: Severe TBI survivors (n = 154), recruited from a level 1 trauma
center.
DESIGN: Prospective cohort study with assessments at 6 and 12 months postinjury.
MAIN MEASURES: Patient Health Questionnaire-9 (PTD symptoms); cognitive composite
score from a neuropsychological assessment battery (cognitive impairment); and
Functional Independence Measure-Cognition (FIM-Cog, self-reported functional
cognition).
RESULTS: Individuals with and without PTD did not differ with respect to
cognitive impairment. However, antidepressant use, regardless of PTD status, was
associated with cognitive impairment. Individuals with PTD reported lower FIM-Cog
scores at both time points compared with those without PTD. In a post hoc
longitudinal analysis, individuals with late-onset PTD had worse cognitive
impairment.
CONCLUSION: These results suggest that antidepressant use impairs cognition among
individuals without PTD. Also, PTD did not directly affect cognitive impairment
but may affect functional cognitive limitations through self-evaluation and
apathy/motivation factors. 

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