Women nearly 50% likelier to develop depression after TBI compared with men, study finds

Key takeaways:

• After TBI, 29.3% of women and 21.9% of men developed depression.
• Women should be aware of the risks, signs and symptoms of depression after a head injury, researchers said.

Women were nearly 50% more likely to develop depression after experiencing traumatic brain injury compared with men, according to a study presented at the American Society of Anesthesiologists annual meeting.

“Most studies showing the link between TBI and depression have focused on men,” Isaac G. Freedman, MD, MPH, a resident physician at Harvard Medical School, said in a press release. “Our study represents the highest quality evidence to date that a patient’s gender influences the risk of depression after traumatic brain injury.”

In their systematic review and meta-analysis, Freedman and colleagues evaluated nine studies comprising 691,364 participants who experienced TBI, 360,605 of whom were women.

The researchers found that 29.3% of women and 21.9% men developed depression following TBI.

Overall, women had 48% greater odds of developing depression after TBI vs. men (OR = 1.48; 95% CI, 1.3-1.68).

Freedman and colleagues said the ORs for depression were significantly heterogenous across trials, so they focused on a subset of five studies without significant heterogeneity and found that the association between TBI and depression remained (OR = 1.48; 95% CI, 1.28-1.7).

According to the release, although the researchers could not determine why TBI was more likely to lead to depression in women, women are more likely to have depression overall than men, “which is associated with fluctuating reproductive hormones.”

“The resulting difference in brain circuits between men and women in combination with factors such as lack of social support, socioeconomic status and inadequate treatment options may make some women more vulnerable to post-TBI depression,” Benjamin F. Gruenbaum, MD, PhD, an assistant professor of anesthesiology and perioperative medicine, said in the release.

Freedman said women should be aware of the potential risks for depression following a head injury — even if they have no previous history of mental health issues — and to know signs and symptoms. Physicians, meanwhile, should consider screening women for depression after TBI.

The researchers concluded that more studies are needed to explain the relationship between TBI and depression and to develop gender-specific interventions to prevent and treat individuals with depression following TBI.

References:

• Freedman IG, et al. Influence of gender on depression following traumatic brain injury: Systematic review and meta-analysis. Presented at: American Society of Anesthesiologists annual meeting; Oct. 13-17, 2023; San Francisco.
• Women at much higher risk of depression after traumatic brain injury, analysis finds. https://www.asahq.org/about-asa/newsroom/news-releases/2023/10/women-at-much-higher-risk-of-depression. Published Oct. 16, 2023. Accessed Oct. 16, 2023.