%0 Journal Article
%T Depression following traumatic brain injury: impact on post-hospital residential rehabilitation outcomes
%J NeuroRehabilitation
%D 2017
%A Lewis, Frank D.
%A Horn, Gordon J.
%V 40
%N 3
%P 401-410
%X BACKGROUND: A need exists to better understand the impact of depression on functional outcomes following TBI. <br><br>OBJECTIVES: To evaluate the prevalence and severity of depression among a large group of chronic TBI adults; to determine the impact of depression on outcomes of post-hospital residential rehabilitation programs; and to assess effectiveness of post-hospital residential rehabilitation programs in treating depression. <br><br>METHODS: 820 adults with moderate to severe traumatic brain injury (TBI) were assigned to one of four groups based on MPAI- 4 depression ratings: (1) Not Depressed, (2) Mildly Depressed, (3) Moderately Depressed, and (4) Severely Depressed. Functional status was assessed at admission and discharge with the MPAI-4 Participation Index. Differences among groups were evaluated using conventional parametric tests. Rasch analysis established reliability and validity of MPAI-4 data. <br><br>RESULTS: Rasch analysis demonstrated satisfactory construct validity and internal consistency (Person reliability = 0.89-0.92, Item reliability = 0.99). Of the 820 subjects, 39% presented with moderate to severe depressive symptoms at admission, These subjects demonstrated significantly higher MPAI-4 Participation scores than the mild and not depressed groups. Depressed groups realized significant improvement in symptoms, but, those remaining depressed at discharge had significantly greater disability than those who improved. <br><br>CONCLUSIONS: Depressive symptoms had a deleterious impact on outcome. Remediation of symptoms during rehabilitation significantly improved outcomes.<p /> <p>Language: en</p>
%G en
%I IOS Press
%@ 1053-8135
%U http://dx.doi.org/10.3233/NRE-161427