University of Washington

Department of Rehabilitation Medicine

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Depression and treatment preferences after traumatic brain injury


Fann, J. R., Jones, A. L., Dikmen, S. S., Temkin, N. R., Esselman, P. C., Bombardier, C. H



Publication Info:

Journal of Head Trauma Rehabilitation, 24(4):272-278


OBJECTIVE: To determine preferences for depression treatment modalities and settings among persons with traumatic brain injury (TBI).
DESIGN: Telephone survey. Depression status was determined using the Patient Health Questionnaire-9.
SETTING: Harborview Medical Center, Seattle, Washington, the level I trauma center serving Washington, Idaho, Montana, and Alaska.
PARTICIPANTS: One hundred forty-five adults, English-speaking consecutive patients admitted with complicated mild to severe TBI.
MAIN OUTCOME MEASURES: Telephone survey within 12 months post-TBI ascertaining preferences for depression treatment modalities and settings.
RESULTS: More patients favored physical exercise or counseling as a depression treatment than other treatment modalities. Group therapy was the least favored modality. Patients favored speaking with a clinician in the clinic or over the telephone and were less likely to communicate with a clinician over the Internet. Subjects with probable major depression or a history of antidepressant use or outpatient mental health treatment were more likely to express a preference for antidepressants for treatment of depression.
CONCLUSIONS: This study underscores the importance of understanding patient preferences and providing patient education in selecting a treatment for depression after TBI. Future studies should examine psychotherapy and alternative treatment modalities and delivery models for the management of depression in this vulnerable population.

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