Sixty-six patients admitted for the treatment of acute closed head
injury were assessed for the presence of mood disorders during the in-
hospital period and at 3-, 6-, and 12-month follow-ups. Diagnosis was made
using a structured psychiatric interview and DSM-III criteria. A total of
28 patients had major depression at some time during the study: 17 had
acute-onset depression and 11 had delayed-onset depression. Acute-onset
depressions are related to lesion location and may have their etiology in
biological responses of the injured brain, whereas delayed depressions may
be mediated by psychosocial factors, suggesting psychological reaction as a
possible mechanism.
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