{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:12:42Z","timestamp":1792649562490,"version":"4.5.0"},"reference-count":48,"publisher":"SAGE Publications","issue":"7-8","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>\n                    The chronic mental health consequences of mild traumatic brain injury (TBI) are a leading cause of disability. This is surprising given the expectation of significant recovery after mild TBI, which suggests that other injury-related factors may contribute to long-term adverse outcomes. The objective of this study was to determine how number of prior injuries, gender, and environment\/context of injury may contribute to depressive symptoms after mild TBI among deployed United States service members and veterans (SMVs). Data from the Long-term Impact of Military-Relevant Brain Injury Consortium Prospective Longitudinal Study was used to assess TBI injury characteristics and depression scores previously measured on the Patient Health Questionnaire-9 (PHQ-9) among a sample of 1456 deployed SMVs. Clinical diagnosis of mild TBI was defined via a multi-step process centered on a structured face-to-face interview. Logistical and linear regressions stratified by gender and environment of injury were used to model depressive symptoms controlling for sociodemographic and combat deployment covariates. Relative to controls with no history of mild TBI (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009280), the odds ratios (OR) for moderate\/severe depression (PHQ-9\u2009\u2265\u200910) were higher for SMVs with one mild TBI (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009358) OR: 1.62 (95% confidence interval [CI] 1.09\u20132.40,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.016) and two or more mild TBIs (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009818) OR: 1.84 (95% CI 1.31\u20132.59,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Risk differences across groups were assessed in stratified linear models, which found that depression symptoms were elevated in those with a history of multiple mild TBIs compared with those who had a single mild TBI (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Combat deployment-related injuries were also associated with higher depression scores than injuries occurring in non-combat or civilian settings (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Increased rates of depression after mild TBI persisted in the absence of post-traumatic stress disorder. Both men and women SMVs separately exhibited significantly increased depressive symptom scores if they had had combat-related mild TBI. These results suggest that contextual information, gender, and prior injury history may influence long-term mental health outcomes among SMVs with mild TBI exposure.\n                  <\/jats:p>","DOI":"10.1089\/neu.2023.0381","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T09:21:35Z","timestamp":1703064095000},"page":"924-933","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Phenotyping Depression After Mild Traumatic Brain Injury: Evaluating the Impact of Multiple Injury, Gender, and Injury Context"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9211-1271","authenticated-orcid":false,"given":"Eamonn","family":"Kennedy","sequence":"first","affiliation":[{"name":"VA Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center, Salt Lake City, Utah, USA."},{"name":"Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Ozmen","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center, Salt Lake City, Utah, USA."},{"name":"Department of Electrical and Electronics Engineering, Antalya Bilim University, D\u00f6\u015femealt\u0131\/Antalya, T\u00fcrkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin D.","family":"Bouldin","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center, Salt Lake City, Utah, USA."},{"name":"Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samin","family":"Panahi","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center, Salt Lake City, Utah, USA."},{"name":"Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helal","family":"Mobasher","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center, Salt Lake City, Utah, USA."},{"name":"Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Troyanskaya","sequence":"additional","affiliation":[{"name":"H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA."},{"name":"Michael E. DeBakey Veterans Affairs Medical Center, Houston, Holcombe Boulevard Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah L.","family":"Martindale","sequence":"additional","affiliation":[{"name":"Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Research and Academic Affairs Service Line, W. G. (Bill) Hefner VA Healthcare System, Salisbury, North Carolina, USA."},{"name":"Department of Physiology &amp; Pharmacology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria C.","family":"Merritt","sequence":"additional","affiliation":[{"name":"VA San Diego Healthcare System, San Diego, California, USA."},{"name":"Department of Psychiatry, University of California San Diego, La Jolla, California, USA."},{"name":"Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"O'Neil","sequence":"additional","affiliation":[{"name":"VA Portland Health Care System, Portland, Oregon, USA."},{"name":"Department of Psychiatry, Oregon Health &amp; Science University, Portland, Oregon, USA."},{"name":"Department of Medical Informatics &amp; Clinical Epidemiology, Oregon Health &amp; Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott R.","family":"Sponheim","sequence":"additional","affiliation":[{"name":"Minneapolis VA Health Care System, Minneapolis, Minnesota, USA."},{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemay A.","family":"Remigio-Baker","sequence":"additional","affiliation":[{"name":"Traumatic Brain Injury Center of Excellence (TBICoE), Silver Spring, Maryland, USA."},{"name":"Compass Government Solutions, Annapolis, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Presson","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center, Salt Lake City, Utah, USA."},{"name":"Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia A.","family":"Swan","sequence":"additional","affiliation":[{"name":"Department of Psychology, The University of Texas at San Antonio, San Antonio, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Kent","family":"Werner","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom H.","family":"Greene","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth A.","family":"Wilde","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center, Salt Lake City, Utah, USA."},{"name":"Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David F.","family":"Tate","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center, Salt Lake City, Utah, USA."},{"name":"Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Walker","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Service, Richmond Veterans Affairs Medical Center, Richmond, Virginia, USA."},{"name":"Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Jo","family":"Pugh","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center, Salt Lake City, Utah, USA."},{"name":"Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,4]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02143-7"},{"key":"e_1_3_5_3_2","unstructured":"Bains N Abdijadid S. 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