Traumatic brain injury (TBI) is a disruption in the normal function of the brain caused by an external force. It is one of the most common presentations in Accident and Emergency (A&E) departments, especially in young males and older people. Around 50% of people with a head injury will have some form of depression over the next 10 years. The prevalence rates of post TBI depression (PTD) is on average 10 times higher than the general population, and this risk emerges very soon after the injury.
PTD is associated with higher rates of disability, unemployment and premature mortality, including suicide. Those most at risk of PTD are more likely to be older, to be diagnosed with a mild TBI, and have a history of depression. Yet depression is not routinely screened for at TBI presentation, and rarely treated optimally.
Our patient and public involvement group (PPI) recognised the symptoms of depression and also mentioned others such as irritability, confusion, being very sensitive to noises and light. They have highlighted the lack of medical attention paid to mental health issues and that many neuropsychiatric symptoms are overlooked
Preliminary findings from 2 small randomised controlled trials (RCT) suggest that initiation of a selective serotonin reuptake inhibitor (SSRI) within a few weeks of the TBI could significantly reduce the incidence of PTD.
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