Use of the Zung depression scale in patients with traumatic brain injury: 1 year post-injury

Objective: The purpose of this study was to examine if the physical disabilities of patients with traumatic brain injury (TBI) would influence the assessment of depression when using the Zung depression scale. Method: Patients with TBI (n = 59) were assessed 1 year after injury for depression by both a psychiatrist and the use of the Zung depression scale. Results: By psychiatric evaluation, seven of 17 (41%) patients with severe TBI and one of 20 (5%) of the patients with moderate TBI were diagnosed with major depressive disorder. With the Zung depression scale, 10 of 17 (59%) patients with severe TBI met the cut-off (scored > 55) for depression, whereas none of the patients with moderate (n = 20) or mild (n = 22) TBI did. The mean (SD) scores of the somatic scale were 2.91 (0.93), 2.49 (0.92) and 1.25 (0.43) for each group. The mean scores of the affective scale were 2.58 (0.90), 1.85 (0.79) and 1.24 (0.46). For patients with moderate (p < 0.05) and severe (p < 0.10) TBI, scores on the somatic items exceeded scores on their affective items. No difference in somatic and affective scale scores was noted for the patients with mild TBI. Conclusion: The increased endorsement of somatic results may be the somatic difficulties associated with traumatic brain injury.