Objectives Post acquired brain injury (ABI) depression has been implicated in different patient outcomes such as prospective cognition, cognitive impairment, rehabilitation outcome, and quality of life. However, there have been no studies identified in the literature, investigating post ABI insight into depression across varied cognitive abilities. Here we looked at ABI patient insight into their depression across a range of cognitive abilities and compared this to an observed or an objective measure of depression.
Methods A retrospective cohort of 24 individuals with ABI (depressed and non-depressed) seen in a neuropsychiatry outpatient clinic between 2019 and 2020 completed a Patient Health Questionnaire-9 (PHQ-9), self-reported depression scale and had a Neuropsychiatry Inventory Questionnaire(NPI-Q), an observer assessment with a depression domain. The patients also underwent a formal cognitive examination using the Montreal Cognitive Assessment (MoCA).
Results Non-depressed ABI and depressed ABI individuals with a wide range of cognitive abilities demonstrated good insight into their depression when matched to the observer rating. Chi-Square Test showed little variation between the PHQ-9 and NPI-Q Depression data sets; Wilcoxon Signed Ranks Test: Z Test -4.08, p<0.001, Effect Size 0.87 and Spearman’s rho showed positive correlation between the two data sets (Correlation Coefficient 0.527, P<0.008). Therefore, there was a statistically significant agreement between the subjective measure (PHQ-9) and the observed (objective) measure NPIQD and that there was a positive correlation between the two measurement scales for patients with ABI regardless of cognition (as measured by MoCAz score; range -6 to 2.21, mean: -1.17)
Conclusions These findings indicate (1) self-reported measures of depression in ABI are consistent with observed (objective measures) thus can be used to assess depression in this cohort and (2) ABI patients with a wide range of cognitive abilities would appear to have good insight into their depression.
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