Evaluating the Psychometric Properties of 3 Depression Measures in a Sample of Persons With Traumatic Brain Injury and Major Depressive Disorder

Dyer, Joshua R.; Williams, Ruth; Bombardier, Charles H.; Vannoy, Steven D.; Fann, Jesse R.

doi:10.1097/htr.0000000000000177

Cited by 33 publications

(24 citation statements)

References 40 publications

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“…Importantly, the PHQ-9 has been shown to be a sensitive instrument in identifying depression in individuals with TBI, especially in the hospital context (Dyer et al, 2016). The objective of this study was to assess depression, measured by the PHQ-9, in males and females 1 year following TBI.…”

Section: Introductionmentioning

confidence: 99%

Depression in Men and Women One Year Following Traumatic Brain Injury (TBI): A TBI Model Systems Study

et al. 2017

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In the general population, females experience depression at significantly higher rates than males. Individuals with traumatic brain injury (TBI) are at substantially greater risk for depression compared to the overall population. Treatment of, and recovery from, TBI can be hindered by depression; comorbid TBI and depression can lead to adverse outcomes and negatively affect multiple aspects of individuals’ lives. Gender differences in depression following TBI are not well understood, and relevant empirical findings have been mixed. Utilizing the Patient Health Questionnaire-9 (PHQ-9) 1 year after TBI, we examined whether women would experience more severe depressive symptoms, and would endorse higher levels of depression within each category of depression severity, than would men. Interestingly, and contrary to our hypothesis, men and women reported mild depression at equal rates; PHQ-9 total scores were slightly lower in women than in men. Men and women did not differ significantly in any PHQ-9 depression severity category. Item analyses, yielded significant gender differences on the following items: greater concentration difficulties (cognitive problems) in men and more sleep disturbances (psychosomatic issues) in women per uncorrected two-sample Z-test for proportions analyses; however, these results were not significant after the family-wise Bonferroni correction. Our results indicate that, in contrast to the general population, mild depression in persons with moderate to severe TBI may not be gender-specific. These findings underscore the need for early identification, active screening, and depression treatment equally for men and women to improve emotional well-being, promote recovery, and enhance quality of life following TBI.

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Section: Introductionmentioning

confidence: 99%

Depression in Men and Women One Year Following Traumatic Brain Injury (TBI): A TBI Model Systems Study

et al. 2017

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“…37 Fourth, there is evidence that the HAM-D may have suboptimal psychometric properties (e.g., responsiveness to change) in persons with TBI. 38 Finally, the significant psychosocial challenges, exemplified by the large proportion of patients in our study with unstable employment, unmarried and on Medicaid, faced by depressed individuals in the year following TBI has been well-documented. 35 Antidepressants alone are unlikely to adequately treat MDD for many of these individuals.…”

Section: Discussionmentioning

confidence: 67%

Sertraline for Major Depression During the Year Following Traumatic Brain Injury: A Randomized Controlled Trial

Fann

Bombardier

Temkin

et al. 2017

Journal of Head Trauma Rehabilitation

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Objective Major depressive disorder (MDD) is common and associated with impaired functioning after traumatic brain injury (TBI). Few placebo-controlled antidepressant trials exist in this population. We evaluated the efficacy and tolerability of sertraline for MDD within one year of sustaining a TBI. Setting Level I trauma center. Participants Adults with MDD within one year of hospitalization for complicated mild to severe TBI. Design Randomized, double-blind, placebo-controlled trial. Main Measures 12-week treatment response on 17-item Hamilton Depression Rating Scale. We also assessed symptom improvement and remission. Results We randomized 62 participants: 32% sustained a severe TBI, 68% had significant anxiety, 63% had history of prior MDD, 69% had history of alcohol or drug dependence. Depression significantly improved from baseline to 12 weeks in both treatment groups (P<.001). There were no significant differences between the sertraline and placebo groups over 12 weeks on depression severity, response or remission. The sertraline group had significant improvement on speed of information processing compared to the placebo group (P<.006). Conclusion Sertraline monotherapy was not superior to placebo for MDD in people with post-acute complicated mild to severe TBI. Research is needed on the effectiveness of interventions that also address the significant psychosocial needs of this population.

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“…Both instruments have been shown to have strong measurement properties in this sample. 40 We used a structured version of the HAM-D for improved reliability. 41 …”

Section: Methodsmentioning

confidence: 99%

The Relations of Cognitive, Behavioral, and Physical Activity Variables to Depression Severity in Traumatic Brain Injury: Reanalysis of Data From a Randomized Controlled Trial

Bombardier

Fann

Ludman

et al. 2017

Journal of Head Trauma Rehabilitation

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Objective To explore the relations of cognitive, behavioral, and physical activity variables to depression severity among people with traumatic brain injury (TBI) undergoing a depression treatment trial. Setting Community Participants Adults (N=88) who sustained complicated mild to severe TBI within the past 10 years, met criteria for major depressive disorder, and completed study measures. Design Randomized controlled trial Methods Participants were randomized to cognitive-behavioral therapy (n=58) or usual care (n=42). Outcomes were measured at baseline and 16 weeks. We combined the groups and used regressions to explore the relations among theoretical variables and depression outcomes. Main Measures Depression severity was measured with the Hamilton Depression Rating Scale and Symptom Checklist-20. Theory based measures were the Dysfunctional Attitudes Scale (DAS), Automatic Thoughts Questionnaire (ATQ), Environmental Rewards Observation Scale (EROS), and the International Physical Activity Questionnaire (IPAQ). Results Compared to non-TBI norms, baseline DAS and ATQ scores were high and EROS and IPAQ scores were low. All outcomes improved from baseline to 16 weeks except the DAS. The ATQ was an independent predictor of baseline depression. An increase in EROS scores was correlated with decreased depression. Conclusions Increasing participation in meaningful roles and pleasant activities may be a promising approach to treating depression after TBI.

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Evaluating the Psychometric Properties of 3 Depression Measures in a Sample of Persons With Traumatic Brain Injury and Major Depressive Disorder

Abstract: Although each of the 3 measures demonstrated adequate reliability, the efficiency of all 3 instruments was improved with rating scale analysis. The PHQ-9 required the fewest modifications and functions well as a measure of depression among those with TBI.

Cited by 33 publications

References 40 publications

Depression in Men and Women One Year Following Traumatic Brain Injury (TBI): A TBI Model Systems Study

Depression in Men and Women One Year Following Traumatic Brain Injury (TBI): A TBI Model Systems Study

Sertraline for Major Depression During the Year Following Traumatic Brain Injury: A Randomized Controlled Trial

The Relations of Cognitive, Behavioral, and Physical Activity Variables to Depression Severity in Traumatic Brain Injury: Reanalysis of Data From a Randomized Controlled Trial

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