Association between traumatic brain injury and depression stratified by veteran status: Findings from the National Health Interview Survey

Abstract

Globally, traumatic brain injury (TBI) is one of the major causes of morbidity and mortality, with increased incidence reported among veterans. In this study, we explored the relationship between TBI and subsequent screening of depressive symptoms, with further analysis stratified by veteran status. For this study, the National Health Interview Survey data for 2023 was used, which was conducted among 29,522 non-institutionalized U.S. adults aged 18 and older. The patient health questionnaire-2 was used to screen for depression. Self-reported incidence of lifetime TBI was documented. From a Chi-square test, a significant association was observed between TBI and depression (p<0.05), with TBI more commonly being reported among veterans compared to non-veterans. Our regression model indicated that, when adjusted for sociodemographic and health variables, TBI was associated with 1.80 times higher odds of depression among the whole sample population (adjusted odds ratio [aOR] = 1.80; 95% confidence interval [CI] 1.61 - 2.02, p<0.05). When stratified by veteran status, veterans with TBI had 2.92 times higher odds of depression (aOR = 2.92; 95% CI 2.05 - 4.14, p<0.05). Compared to the whole general population, veterans with a brain injury history have higher odds of depression, identifying them as a key group in prioritizing depression management in the United States population.