Persons with traumatic brain injury (TBI) experience high rates of depression, especially during the first six months following their injuries. Neurological and psychosocial factors appear to contribute to depression in this population. Depression following TBI is associated with poor cognitive, behavioral, and functional outcomes. Preliminary studies suggest that people with TBI and major depression may not respond to antidepressant treatment in the same way as depressed persons without TBI, post TBI depression may respond well to selective serotonin reuptake inhibitor (SSRI) antidepressants, that and effective antidepressant treatment is associated with improvements in health status, neuropsychological function, and post-concussive symptoms. No large randomized placebo-controlled studies have been conducted and basic questions remain about the treatment and outcomes of major depression among persons with traumatic injury. As a consequence, depression is not usually assessed after traumatic brain injury, and optimal rehabilitation guidelines for identifying and treating depression have not been established. To address this gap, the proposed study would follow a large consecutive sample of persons hospitalized for moderate to severe TBI to identify those who develop major depression. With those who develop major depression, a 12-week, randomized, double-blind, controlled trial of sertraline would be conducted. The trial would test the hypothesis that sertraline reduces depression related symptoms, as measured by the Hamilton Rating Scale for Depression. Secondary hypotheses to be tested include whether sertraline leads to greater improvement in neuropsychological test performance, post-concussive symptoms and self-reported health status as measured by the SF 36.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD039415-03
Application #
6536201
Study Section
Special Emphasis Panel (ZRG1-BBBP-5 (01))
Program Officer
Ansel, Beth
Project Start
2000-09-20
Project End
2005-05-31
Budget Start
2002-07-01
Budget End
2003-06-30
Support Year
3
Fiscal Year
2002
Total Cost
$511,282
Indirect Cost
Name
University of Washington
Department
Physical Medicine & Rehab
Type
Schools of Medicine
DUNS #
135646524
City
Seattle
State
WA
Country
United States
Zip Code
98195
Fann, Jesse R; Bombardier, Charles H; Temkin, Nancy et al. (2017) Sertraline for Major Depression During the Year Following Traumatic Brain Injury: A Randomized Controlled Trial. J Head Trauma Rehabil 32:332-342
Levis, Brooke; Benedetti, Andrea; Levis, Alexander W et al. (2017) Selective Cutoff Reporting in Studies of Diagnostic Test Accuracy: A Comparison of Conventional and Individual-Patient-Data Meta-Analyses of the Patient Health Questionnaire-9 Depression Screening Tool. Am J Epidemiol 185:954-964
Mackelprang, Jessica L; Bombardier, Charles H; Fann, Jesse R et al. (2014) Rates and predictors of suicidal ideation during the first year after traumatic brain injury. Am J Public Health 104:e100-7
Cook, Karon F; Bombardier, Charles H; Bamer, Alyssa M et al. (2011) Do somatic and cognitive symptoms of traumatic brain injury confound depression screening? Arch Phys Med Rehabil 92:818-23
Bombardier, Charles H; Fann, Jesse R; Temkin, Nancy R et al. (2010) Rates of major depressive disorder and clinical outcomes following traumatic brain injury. JAMA 303:1938-45
Fann, Jesse R; Jones, Audrey L; Dikmen, Sureyya S et al. (2009) Depression treatment preferences after traumatic brain injury. J Head Trauma Rehabil 24:272-8
Bombardier, Charles H; Fann, Jesse R; Temkin, Nancy et al. (2006) Posttraumatic stress disorder symptoms during the first six months after traumatic brain injury. J Neuropsychiatry Clin Neurosci 18:501-8
Fann, Jesse R; Bombardier, Charles H; Dikmen, Sureyya et al. (2005) Validity of the Patient Health Questionnaire-9 in assessing depression following traumatic brain injury. J Head Trauma Rehabil 20:501-11
Dikmen, Sureyya S; Bombardier, Charles H; Machamer, Joan E et al. (2004) Natural history of depression in traumatic brain injury. Arch Phys Med Rehabil 85:1457-64