Lifetime History of Traumatic Brain Injury With Loss of Consciousness and the Likelihood for Lifetime Depression and Risk Behaviors: 2017 BRFSS North Carolina.
Dana Waltzman, Jill Daugherty, Kelly Sarmiento and 1 others
PMID 32769836WHAT IT FOUND
In North Carolina adults, a self-reported lifetime brain injury with loss of consciousness was linked to more reports of lifetime depression, binge drinking, smoking, and e-cigarette use.
Age at first injury did not show the same pattern.
Key findings
0124.4% of the 3771 adults who answered the TBI question reported a lifetime history of TBI with loss of consciousness.
02After adjustment, lifetime TBI with loss of consciousness was associated with increased odds of lifetime depression (adjusted odds ratio 2.1; 95% CI, 1.6-2.8).
03After adjustment, lifetime TBI with loss of consciousness was associated with increased odds of non-binge drinking (adjusted odds ratio 1.3; 95% CI, 1.02-1.7), binge drinking (adjusted odds ratio 1.7; 95% CI, 1.2-2.4), current smoking (adjusted odds ratio 1.8; 95% CI, 1.3-2.4), and current e-cigarette use (adjusted odds ratio 1.7; 95% CI, 1.02-2.97).
STILL TO COME
How it was doneWhat they found
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What it does not show
The data are cross-sectional, so the survey cannot show whether the brain injury came before depression, binge drinking, smoking, or e-cigarette use. TBI history was self-reported and limited to injuries with loss of consciousness, so milder head injuries without loss of consciousness were not counted. The analysis did not measure TBI severity or number of TBIs. 22% of respondents did not answer the TBI question, and those who did not answer differed from those who did on demographic characteristics, lifetime depression, and current binge drinking. The sample is only North Carolina adults, so the results may not apply to other states. For age of first TBI, the estimates were not stable enough to test the association for most outcomes, and a significant bivariate binge-drinking finding disappeared after adjustment.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that a lifetime TBI with loss of consciousness causes depression or risk behaviors. The survey was cross-sectional and self-reported, so it cannot show whether the injury or the symptoms came first.