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Advanced Neurology TBI and depression by veteran status

Table 2. Association between TBI history and depression stratified by veteran status
Variable Whole sample Veteran Non‑veteran
aOR (95% CI), p aOR (95% CI), p aOR (95% CI), p
TBI history 1.80 (1.61 – 2.02), <0.05 2.92 (2.05 – 4.14), <0.05 1.68 (1.49 – 1.90), <0.05
Age 0.98 (0.97 – 0.98), <0.05 0.97 (0.96 – 0.98), <0.05 0.98 (0.977 – 0.984), <0.05
Sex
Female Reference Reference Reference
Male 0.79 (0.71 – 0.87), <0.05 0.71 (0.42 – 1.18), >0.05 0.78 (0.70 – 0.87), <0.05
Race and ethnicity
White Reference Reference Reference
African American 1.15 (0.98 – 1.34), >0.05 1.62 (0.99 – 2.66), >0.05 1.10 (0.93 – 1.30), >0.05
Hispanic 0.75 (0.64 – 0.88), <0.05 1.09 (0.58 – 2.02), >0.05 0.73 (0.62 – 0.86), <0.05
Other 0.92 (0.75 – 1.12), >0.05 1.63 (0.73 – 3.62), >0.05 0.89 (0.72 – 1.09), >0.05
Education status
Below high school Reference Reference Reference
12 grade/GED/Equivalent 1.00 (0.84 – 1.19), >0.05 1.54 (0.57 – 4.14), >0.05 0.96 (0.80 – 1.14), >0.05
th
Associate degree 0.81 (0.65 – 1.0), <0.05 1.00 (0.34 – 2.94), >0.05 0.80 (0.64 – 0.99), <0.05
Bachelor’s degree 0.75 (0.62 – 0.92), <0.05 0.98 (0.34 – 2.82), >0.05 0.74 (0.60 – 0.91), <0.05
Postgraduate degree 0.64 (0.51 – 0.81), <0.05 0.75 (0.24 – 2.36), >0.05 0.64 (0.50 – 0.81), <0.05
General health status
Excellent 0.04 (0.03 – 0.05), <0.05 0.04 (0.02 – 0.10), <0.05 0.04 (0.03 – 0.05), <0.05
Very good 0.06 (0.05 – 0.08), <0.05 0.04 (0.02 – 0.08), <0.05 0.06 (0.05 – 0.08), <0.05
Good 0.12 (0.10 – 0.14), <0.05 0.08 (0.05 – 0.14), <0.05 0.12 (0.10 – 0.15), <0.05
Fair 0.31 (0.26 – 0.36), <0.05 0.19 (0.11 – 0.32), <0.05 0.32 (0.26 – 0.39), <0.05
Poor Reference Reference Reference
Hypertension 1.05 (0.93 – 1.19), >0.05 1.08 (0.73–1.60), >0.05 1.04 (0.91 – 1.18), >0.05
Cardiovascular disease 1.08 (0.89 – 1.31), >0.05 1.14 (0.69 – 1.19), >0.05 1.07 (0.87 – 1.33), >0.05
Cancer 0.82 (0.70 – 0.97), <0.05 0.73 (0.45 – 1.19), >0.05 0.85 (0.71 – 1.02), >0.05
Diabetes 0.98 (0.84 – 1.14), >0.05 1.09 (0.69 – 1.71), >0.05 0.96 (0.82 – 1.14), >0.05
Abbreviations: aOR: Adjusted odds ratio; TBI: Traumatic brain injury.
within 8 weeks after treatment initiation. However, some of their prior service and subsequent depression diagnosis.
cases advance to chronic conditions and require extensive Nonetheless, the ramifications of depression are not solely
management straining the already fragile healthcare system. confined to the health of the affected individual as it has
25
Nurses, medics, corpsmen, and primary healthcare providers ripple effects for the society more broadly due to increased
should be included in a holistic treatment approach where healthcare utilization. The robust association between
28
education and monitoring would be considered as integral TBI and positive screening for depression among veterans
components. Any suspicion of depression among veterans in later life underscores the necessity for implementing
with recent TBI should be addressed with utmost caution. targeted mental health screening for vulnerable individuals.
26
Previous research demonstrated that females are more likely Since the incidence of depression among veterans are
to get diagnosed with depression compared to males. For higher than the general population, routine screening after
27
future research, it remains to be seen whether gender of each TBI incident might alleviate the risk up to a certain
veterans has any interacting effect on the association between extent. This would improve long-term outcomes and
29
TBI and depression. reduce the burden on already scarce healthcare resources.
From a public health perspective, our study offers While the PHQ-2 is a useful screening tool for depression
important contributions in shaping intervention strategies among individuals, the longer and more robust PHQ-9
for people with a history of TBI. This is even more impactful could also provide more data and clarity while screening
for veterans who are more prone to TBI due to the nature for depression in high-risk groups. 30

Volume 4 Issue 3 (2025) 74 doi: 10.36922/AN025050008