Research Reports - Increased risk of new-onset depression in patients with traumatic brain injury and hyperlipidemia: the important role of statin medications

J Clin Psychiatry. 2016 Mar 1. [Epub ahead of print]

Wee HY(1), Ho CH, Liang FW, Hsieh KY, Wang CC, Wang JJ, Chio CC, Chang CH, Kuo
JR.

OBJECTIVE: Depression is a common complication after traumatic brain injury
(TBI). This study aimed to evaluate the risk of hyperlipidemia for new-onset
depression after TBI and the role of statin medications using a longitudinal
population database.
METHOD: A matched longitudinal cohort study of 3,792 subjects (1,264 TBI patients
[ICD-9-CM code: 801-804 and 850-854] with preexisting hyperlipidemia [ICD-9-CM
code: 272.0, 272.1, 272.2, 272.4] and 2,528 age- and sex-matched TBI patients
without hyperlipidemia) was conducted using the Taiwan Longitudinal Health
Insurance Database from January 2001 to December 2008. The incidence and hazard
ratios (HRs) for the development of new-onset depression (ICD-9-CM code:
296.2X-296.3X, 300.4, and 311.X) after TBI were compared between the 2 groups.
RESULTS: The incidence rate of depression in TBI with preexisting hyperlipidemia
was 136.61 per 10,000 person-years. TBI patients with preexisting hyperlipidemia
had a 1.72-fold increased incidence rate ratio compared with those without
hyperlipidemia (P = .0056). A Cox model showed hyperlipidemia to be an
independent predictor of depression (HR = 1.61; 95% CI, 1.03-2.53). TBI patients
with hyperlipidemia who were not treated with statins experienced a 1.95-fold
incidence risk ratio (P = .0017) and higher risk of new-onset depression (HR =
1.61; 95% CI, 1.03-2.53) compared to TBI patients without hyperlipidemia.
CONCLUSIONS: Preexisting hyperlipidemia could be an independent predictor of
new-onset depression in TBI patients, and TBI patients with preexisting
hyperlipidemia who were not treated with statins presented a higher risk of
new-onset depression than TBI patients without hyperlipidemia. Our findings may
provide some insight into the important role of statin medications in the
development of new-onset depression in patients with traumatic brain injury.
 

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