@article{ref1,
title="Characterizing depression after traumatic brain injury using a symptom-oriented approach",
journal="Journal of affective disorders",
year="2023",
author="Carmichael, Jai and Ponsford, Jennie and Gould, Kate Rachel and Spitz, Gershon",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Progress in addressing depression after traumatic brain injury (TBI) has been limited. Traditional approaches to measuring depression classify individuals with diverse symptoms as having the same problem. We adopted a novel, symptom-oriented approach to characterize post-TBI depression, emphasizing specific symptoms rather than the number of symptoms. <br><br>METHODS: We assessed depressive symptoms cross-sectionally in 393 participants with moderate-severe TBI (range 0.4-35.4 years post-injury; M = 12.6) using the Inventory of Depressive and Anxiety Symptoms - Expanded Version (IDAS-II). We analyzed symptoms of DSM-5 major depressive disorder (MDD), separating compound symptoms into sub-symptoms. We quantified depression heterogeneity across 16 specific symptoms and explored associations between each symptom and personal, injury-related, treatment, and functional/psychosocial outcome factors. <br><br>RESULTS: 28 % of participants self-reported a current depression diagnosis, and 31 % met DSM-5 symptom criteria for MDD. Depressed participants (according to either self-reported diagnosis or MDD symptom criteria) were more likely to endorse each specific depressive symptom, including those that overlap with TBI. Post-TBI depression was highly heterogenous, with over 90 % of depressed participants showing a unique symptom profile not shared with any other individual. This heterogeneity was meaningful, as specific depressive symptoms had distinct associations with personal, injury-related, treatment, and outcome factors. LIMITATIONS: Cross-sectional design. We only analyzed DSM-5 MDD symptoms, and some symptoms were assessed using only one item. <br><br>CONCLUSIONS: A symptom-oriented approach to post-TBI depression captures an individual's unique profile of depressive symptoms, which relate differently to outcomes and other factors. We recommend future studies investigating post-TBI depression analyze specific symptoms alongside overall depression scores.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2023.10.130",
url="http://dx.doi.org/10.1016/j.jad.2023.10.130"
}