Related Experiment Video
Updated: Sep 2, 2026
Murine Model of Controlled Cortical Impact for the Induction of Traumatic Brain Injury
Published on: August 16, 2019
The Impact of Depression on Mortality Risk After Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study
Amanda R Rabinowitz1, Brennan Hickson, Raj G Kumar
1Author Affiliations: Jefferson Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (Dr Rabinowitz, Dr Hart, and Dr Whyte); Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania (Dr Rabinowitz, Dr Hart, and Dr Whyte); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama (Hickson); Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York (Dr Kumar); Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington (Dr Bombardier); Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana (Dr Hammond); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia (Seel); and Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts (Zafonte).
Objective:
To examine whether depressive symptoms at 1 year postinjury are associated with all-cause mortality among individuals with moderate-to-severe traumatic brain injury (TBI) who received inpatient rehabilitation, accounting for sociodemographic, functional, and mental health factors.
Setting:
Community.
Participants:
A total of 2812 individuals enrolled in the TBI Model Systems National Database with 1-year postinjury follow-up interviews between October 1, 2007, and October 1, 2013, and a follow-up within 5 years of injury.
Design:
Prospective cohort study, using secondary analysis of longitudinal data.
Main Measures:
Depression (Patient Health Questionnaire-9) and all-cause mortality.
Results:
The rate of high depressive symptom burden at 1-year follow-up was 28.5%, and the overall death rate was 8.8% across the study follow-up period. In age-adjusted models, higher depressive symptom burden at 1 year was associated with increased mortality risk; however, this association was progressively attenuated after adjustment for functional status and preinjury mental health variables and was no longer statistically significant in fully adjusted models. Sensitivity analyses using multiple imputation yielded similar results.
Conclusion:
Findings suggest that depressive symptom burden at 1 year postinjury is not independently associated with 5-year mortality after accounting for functional status and preinjury mental health history. Depression may, nonetheless, function as a clinically meaningful marker of broader vulnerability. Further research is warranted to explore whether targeting depression and functional recovery influence long-term survival after TBI.
