Traumatic Brain Injury Increases Risk for Mood Disorders in Adolescence

Alain Joffe, MD, MPH, FAAP

In controlled analysis, TBI doubled the risk for new onset mood disorders within 5 years.

Traumatic brain injury (TBI) increases risk for subsequent mood disorders in adults, but the relation in adolescents is uncertain. Investigators used a Taiwanese health insurance database to compare ICD-9 diagnoses of mood disorders between patients (age range, 10–24 years) who had two outpatient or one inpatient claim for TBI in 2000–2004 and age- and sex-matched controls with non–TBI-related claims in the same year. Patients with preexisting mood disorders were excluded.

Among 15,000 patients with TBI (58% male; 58% aged 10–19 years) and 76,000 randomly chosen controls, 3.0% and 1.5%, respectively, developed a mood disorder within 5 years. Risk for mood disorder within 5 years in the TBI group remained doubled after adjustment for demographic variables and premorbid conditions. Adjusted hazard ratio (aHR) for mood disorder was higher among TBI patients who had not been hospitalized than among those who had been hospitalized (2.15 and 1.58, respectively). Risk was also significantly increased among older patients (age 15–19 and 20–24 years) but not younger patients (age 10–14 years). Among males, risk was significantly increased for major depression (aHR, 2.44) and bipolar disorder (aHR, 2.57), but not for unspecified mood disorders. Among females, risk was significantly increased for all three disorders (aHR, 1.77, 2.14, 2.16, respectively).

Citation(s):

Tsai M-C et al. Mood disorders after traumatic brain injury in adolescents and young adults: A nationwide population-based cohort study. J Pediatr 2013 Oct 8; [e-pub ahead of print].