Neuropsychological outcomes, clinical characteristics and depression in a group with traumatic brain injury : a retrospective review

Abstract

Traumatic brain injury (TBI) is a multi-faceted disease that affects individuals on physical, cognitive and emotional levels. The specific aims of this research are to explore the prevalence of depression and the relationship between depression, neuropsychological performance and clinical variables in a cohort with TBI. This is accomplished through the retrospective review of 75 neuropsychological reports containing information on clinical variables, performance on neuropsychological measures and Beck Depression Inventory- Second Edition (BDI-II) scores of individuals who had sustained a TBI. The neuropsychological domains assessed via the standardized neuropsychological measures were the domains of attention, concentration, memory, learning, non-verbal and abstract reasoning, manual dexterity, verbal recall, working memory, perception, psychomotor performance, incidental learning, concept formation and verbal fluency. These results were statistically analysed to determine relationships with depression and clinical variables. The investigations undertaken in this study signified particularly pertinent relationships in the interactions among the variables of interest. Higher education level was found to be extremely critical in assisting retention of cognitive abilities following a TBI. Primary language was also a significant differentiator of performance among tests. Age had contrasting effects, with increasing age being favourable on the Similarities Test and related to poorer performance on the Letter Cancellation Test. Increasing GCS scores were related to slower performance on the Letter Cancellation Test and decreased performance on the RAVLT Free Recall Test. Longer PTA duration was related to worse performance on the Matrix Reasoning Test. These results indicate that these indicators of injury severity did not correlate with cognitive performance in this sample after TBI. The high incidence of depression in this study confirms that major depression is a very common occurrence after TBI. This has widespread implications for patient and family counselling, and psychotropic interventions in treatment planning after TBI. Further research on the emotional and cognitive aspects of TBIs within the South African population is needed to supplement the lack of information currently available. It is recommended that further studies build on the current study by exploring larger samples, and using more stratification specificity in terms of the type of injury sustained as well as functional outcomes. Copyright