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Paediatric Traumatic Brain Injury and Long-Term Antidepressant Use: A Nationwide Register-Based Cohort Study

Juho Laaksonen1, Ville Ponkilainen2, Julius Möttönen1

  • 1Tampereen yliopisto Laaketieteen ja terveysteknologian tiedekunta, Tampere, Pirkanmaa, Finland.

Acta Paediatrica (Oslo, Norway : 1992)
|June 3, 2025
PubMed

Insights

Children with paediatric traumatic brain injury (pTBI) have an increased risk of antidepressant use, particularly after surgery and for females. This elevated risk persists for up to 9 years post-injury.

Area of Science:

  • Neuroscience
  • Public Health
  • Pediatrics

Background:

  • Paediatric traumatic brain injury (pTBI) is a significant health concern.
  • The long-term mental health consequences of pTBI, specifically antidepressant use, are not well understood.

Purpose of the Study:

  • To investigate the association between paediatric traumatic brain injury (pTBI) and the subsequent use of antidepressant medication.
  • To identify risk factors and temporal trends in post-traumatic antidepressant use among pediatric patients.

Main Methods:

  • A nationwide Finnish retrospective cohort study (1998-2018) analyzed data from 71,969 pTBI patients and 64,856 controls.
  • Antidepressant medication data were obtained from the Finnish Social Insurance Institution.
  • Kaplan-Meier analyses and Cox regression were used to determine the primary outcome of post-traumatic paediatric antidepressant use.

Main Results:

  • The cumulative incidence of antidepressant use was higher in pTBI patients compared to controls, increasing significantly over 20 years.
  • Cox regression revealed a higher long-term risk of antidepressant use in pTBI patients (HR 1.31 up to 9 years).
  • Operatively treated pTBI showed a substantially higher risk (HR 4.45 after 2 years), with females exhibiting a greater risk (HR 2.60 after 1 year) than males (HR 1.54).

Conclusions:

  • Antidepressant use is significantly elevated following paediatric traumatic brain injury (pTBI), especially after the first year.
  • The risk is particularly pronounced in females and those undergoing operative treatment.
  • This increased risk of antidepressant use persists for up to 9 years post-pTBI, highlighting the need for long-term mental health monitoring.
Abstract

Keywords:
antidepressantdepressionpaediatrictraumatic brain injury

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