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Chapter 10. Mood Disorders

Ricardo E. Jorge, M.D.; Robert G. Robinson, M.D.
DOI: 10.1176/appi.books.9781585624201.675726

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Associations between traumatic brain injury (TBI) and a variety of neuropsychiatric disorders have been reported in the medical literature for many years. Lishman (1973), in his classic study on the Oxford collection of head injury records, analyzed potential etiological factors involved in the development of psychiatric disturbances following TBI. These studies stressed the importance of biological variables such as the extent of brain damage, lesion location, and the presence of posttraumatic epilepsy in determining the type and duration of psychiatric disorder.

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Figure 10–1. Frequency of major depression after traumatic brain injury in different samples.

Figure 10–2. Frequency of mood disorders during the first year after traumatic brain injury (TBI).Frequency of mood disorders was significantly greater in TBI patients than in a control group of patients with orthopedic injuries.

Figure 10–3. Coexistent anxiety and aggression among patients with major depressive disorder after traumatic brain injury.

Figure 10–4. Factor structure of depression and anxiety symptoms after traumatic brain injury.

Figure 10–5. Gray matter volume in patients with major depressive disorder after traumatic brain injury (TBI).TBI patients with major depression showed significantly lower frontal gray matter volumes than a group of nondepressed TBI patients matched for age, gender, and severity of TBI.*Frontal gray matter volumes were significantly decreased in major depressed patients (P <0.009).

Figure 10–6. Mood disorders and hippocampal volumes of traumatic brain injury (TBI) patients.When compared with TBI patients who did not develop depression, hippocampal volume was significantly reduced among depressed TBI patients with moderate to severe injuries.

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