Research Reports - Mood disorders after traumatic brain injury in adolescents and young adults

J Pediatr. 2014 Jan;164(1):136-141

Tsai MC(1), Tsai KJ(2), Wang HK(3), Sung PS(4), Wu MH(5), Hung KW(6), Lin SH(7)

OBJECTIVE: To delineate the relationship between traumatic brain injury (TBI) and
mood disorders from population-based data in Taiwan.
STUDY DESIGN: This prospectively followed cohort study involved a subset of the
National Health Insurance Research Database containing complete inpatient and
outpatient data of 1 million randomly drawn beneficiaries. We included 10- to
24-year-old patients (n = 15,203) receiving the diagnosis of TBI in ambulatory
visits or hospitalization from 2000-2004 and their age- and sex-matched
comparison insureds using health service in the same year (n = 76,015). Diagnosis
of mood disorders was recorded within 5 years after the traumatic event or index
use of health service. Baseline demographics, clinical characteristics, and
premorbid psychiatric conditions were compared using χ(2) analysis. Increased
risk during the 5-year follow-up period was represented by crude and adjusted
hazard ratios with 95% CI using a Cox proportional hazard regression.
RESULTS: A total of 451/15,203 patients with TBI (2.97%) received a diagnosis of
mood disorders in the 5-year follow-up period compared with 1153/97,445
individuals (1.52%) without antecedent TBI. After adjusting for select premorbid
comorbidities, TBI remained a significant predisposing factor with a 1.96-fold
(95% CI 1.74-2.22) increase in risk of mood disorders.
CONCLUSIONS: Our findings show a higher likelihood of manifesting mood disorders
in adolescents and young adults who sustained a prior TBI. Health professionals
should carefully monitor both the physical and psychological impacts of head
trauma.

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