BACKGROUND: Depression and traumatic brain injury (TBI) substantially contribute to the United States healthcare burden. Depression is a known risk factor for prolonged recovery after TBI. However, the effect of depression treatment on health care utilization has yet to be studied.
OBJECTIVE: To examine whether an association exists between pharmacologic treatment of depression at the time of mild or concussive TBI and the number of subsequent clinician visits for persistent injury-related symptoms.
DESIGN: Retrospective medical record review. SETTING: Tertiary care medical center. PARTICIPANTS: A total of 120 patients (mean age 45.6 years) with a history of depression who subsequently experienced a mild or concussive TBI were included.
METHODS: Individuals were identified with co-occurring diagnoses of depression and mild or concussive TBI by retrospective electronic medical record review. The diagnosis of depression must have preceded the diagnosis of TBI. MAIN OUTCOME: The number of clinician visits for post-injury symptoms were counted at 3, 6, and 12 months post-injury.
RESULTS: Clinician visits for persistent injury-related symptoms were significantly fewer at all 3 time points for the group treated for depression at time of injury.
CONCLUSIONS: Depressed individuals who were pharmacologically treated for depression at the time of TBI had significantly fewer clinician visits for persistent post-injury symptoms than those not pharmacologically treated for depression at the time of injury. Routine depression screening in patients with a high risk for TBI may identify a mood disorder which could contribute to persistent symptoms if left untreated, with its effective management potentially reducing health-related costs. LEVEL OF EVIDENCE: III.