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Harvey S. Levin, PhD; Stephen R. McCauley, PhD; Claudia Pedroza Josic, PhD; Corwin Boake, PhD; Sharon A. Brown, PhD; Heather S. Goodman, MD, PhD; Shirley G. Merritt, MD; Susan I. Brundage, MD, MPH

Arch Gen Psychiatry. 2005;62:523-528.

Context  Minimizing negative consequences of major depression following traumatic brain injury is an important public health objective. Identifying high-risk patients and referring them for treatment could reduce morbidity and loss of productivity.

Objective  To develop a model for early screening of patients at risk for major depressive episode at 3 months after traumatic brain injury.

Design  Prediction model using receiver operating characteristic curve.

Setting  Level I trauma center in a major metropolitan area.

Participants  Prospective cohort of 129 adults with mild traumatic brain injury.

Main Outcome Measures  Center for Epidemiologic Studies Depression Scale score and current major depressive episode module of the Structured Clinical Interview for the DSM-IV.

Results  A prediction model including higher 1-week Center for Epidemiologic Studies Depression Scale score, older age, and computed tomographic scans of intracranial lesions yielded 93% sensitivity and 62% specificity.

Conclusion  This study supports the feasibility of identifying patients with mild traumatic brain injury who are at high risk for developing major depressive episode by 3 months’ postinjury, which could facilitate selective referral for potential treatment and reduction of negative outcomes.

Author Affiliations: Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas-Houston Medical School (Drs Levin, McCauley, Josic, Boake, and Brown), and Departments of Neurosurgery (Dr Levin), Psychiatry and Behavioral Sciences (Dr Levin, Brown, Goodman, and Merritt), and Surgery (Dr Brundage), Baylor College of Medicine, Houston. Dr Josic is now with the Department of Biostatistics, University of Texas School of Public Health, Houston. Dr Brundage is now with the Department of Surgery, Stanford University Medical Center, Stanford, Calif.

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