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 χ2 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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Article Info
Publication History
Published online: October 10, 2013
Accepted:
August 21,
2013
Received in revised form:
July 2,
2013
Received:
February 8,
2013
Footnotes
Supported by the National Cheng Kung University Hospital (NCKUH- 10001022 ). The authors declare no conflicts of interest.
Identification
Copyright
© 2014 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
