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Journal of Head Trauma Rehabilitation:
doi: 10.1097/HTR.0b013e3181a66342
Focus on Clinical Research and Practice

Depression Treatment Preferences After Traumatic Brain Injury

Fann, Jesse R. MD, MPH; Jones, Audrey L. BA; Dikmen, Sureyya S. PhD; Temkin, Nancy R. PhD; Esselman, Peter C. MD; Bombardier, Charles H. PhD

Section Editor(s): Bell, Kathleen R. MD; Hart, Tessa PhD; Caplan, Bruce PhD, ABPP (Senior Editor); Bogner, Jennifer PhD (Associate Editor)

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Objective: To determine preferences for depression treatment modalities and settings among persons with traumatic brain injury (TBI).

Design: Telephone survey. Depression status was determined using the Patient Health Questionnaire-9.

Setting: Harborview Medical Center, Seattle, Washington, the level I trauma center serving Washington, Idaho, Montana, and Alaska.

Participants: One hundred forty-five adults, English-speaking consecutive patients admitted with complicated mild to severe TBI.

Main Outcome Measures: Telephone survey within 12 months post-TBI ascertaining preferences for depression treatment modalities and settings.

Results: More patients favored physical exercise or counseling as a depression treatment than other treatment modalities. Group therapy was the least favored modality. Patients favored speaking with a clinician in the clinic or over the telephone and were less likely to communicate with a clinician over the Internet. Subjects with probable major depression or a history of antidepressant use or outpatient mental health treatment were more likely to express a preference for antidepressants for treatment of depression.

Conclusions: This study underscores the importance of understanding patient preferences and providing patient education in selecting a treatment for depression after TBI. Future studies should examine psychotherapy and alternative treatment modalities and delivery models for the management of depression in this vulnerable population.

© 2009 Lippincott Williams & Wilkins, Inc.


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