Effects of Depression and Antidepressant Use on Cognitive Deficits and Functional Cognition Following Severe Traumatic Brain Injury.
Michelle D Failla, Shannon B Juengst, Kristin M Graham and 2 others
PMID 26828711WHAT IT FOUND
In severe TBI, depression was not linked to worse cognitive test scores, but people with depression reported more everyday cognitive limitations.
Antidepressant use was linked to worse cognitive scores, not necessarily causing them.
Key findings
01The overall cognitive composite showed no significant effect of post-TBI depression.
02People with post-TBI depression reported worse functional cognition, including memory at 6 months and memory, problem-solving, and social interaction at 12 months.
03Antidepressant use was associated with worse scores on several neuropsychological tests at 6 and 12 months.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
This was an observational study, so it cannot show that depression or antidepressants caused cognitive impairment or functional limitations. The paper did not capture why participants were taking antidepressants, so people without depression may have been treated for sleep or other post-TBI symptoms. Functional cognition was self-reported, and people with depression may report more limitations even when cognitive test scores are similar. The sample was mostly people with severe TBI, so results may not apply to milder injuries. The supplied text does not state the total cohort size; the longitudinal analysis included 98 people with PHQ-9 data at both 6 and 12 months. Pre-injury mood disorders were mostly self-reported. The FIM-Cog social interaction subscale automatically reduces by one point for people on antidepressants or with reported depression, which may affect functional cognition scores.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that antidepressants caused worse cognition after severe TBI. The study observed antidepressant use, and the authors said it was not clear how antidepressant use directly affects cognitive impairment or functioning post-TBI.