Diagnosing depression in persons with brain injuries: a look at theories, the DSM-IV and depression measures

There have been numerous articles published on the incidence of depression after brain injury. Unfortunately, the studies have shown the incidence of depression varies widely depending on multiple factors: definition of 'depression', time of assessment post-injury and type of measure used. It is well known that traumatic brain injury (TBI) sequelae and depressive symptoms overlap, contributing further to measurement error and ultimately epidemiologic report of depression. This paper reviews different theories of depression, the DSM-IV depression diagnoses, the overlap in depression and TBI symptoms and depression measures and how they contribute to possible diagnostic error. This paper also discusses evaluation and treatment considerations when assessing depression in a person with a TBI.