Abstract: Objective   This study was designed to investigate the characteristics of clinical diagnosis and treatment of major depression in the rehabilitation phase of traumatic brain injury (TBI). Methods   32 patients, suffered from TBI and discharged with major depression, were recruited in this study. Their TBI characteristics, clinical manifestation and management of major depression were comprehensively analyzed. The therapeutic effects of different treating regimen were further compared as well. Results   10 cases presented with mild-to-moderate (31.25%); 18 cases with moderate (56.25%); and 4 cases with severe depression (12.5%). Their clinical manifestations are easy fatigue (22 cases), irritability (21 cases), hypologia (20 cases), insomnia (15 cases), and concentration deficits (14 cases). 15 patients suffered from reduced hormone level (12 cases with hypocortisolism, 10 with hypothyroidism, and 3 with hypogonadotropinism and hypoestrogenism). After supportive psychotherapy, hormone replacement and antidepressant treatment, 68.75% of depressive patients were in complete remission, 28.13% in partial remission, 3.13% with no obvious improvement. Conclusion    Major depression is a common complication in the rehabilitation phase of TBI, and post-traumatic hypopituitarism might be a major contribution factor. Appropriate and prompt treatment could significantly improve or even cure the major depression in TBI patients.

Key words: brain injury, Rehabilitation, Citalopram, treatment