Research Reports - Prevalence and risk factors of anxiety and depressive disorders following traumatic brain injury

 J Neurotrauma. 2016 Jan 5. [Epub ahead of print]

Scholten AC(1,)(2), Haagsma JA(3), Cnossen MC(4), Olff M(5), Van Beeck EF(6),
Polinder S(7).

This review examined the pre- and post-injury prevalence of and risk factors for
anxiety disorders and depressive disorders following traumatic brain injury
(TBI), based on evidence from structured diagnostic interviews. A systematic
literature search was conducted in EMBASE, MEDLINE, Cochrane Central, PubMed,
PsycINFO, and Google Scholar. We identified studies in civilian adults with TBI
reporting on the prevalence of anxiety and depressive disorders using structured
diagnostic interviews, and assessed their quality. Pooled pre- and post-injury
prevalence estimates of anxiety disorders and depressive disorders were computed.
A total of 34 studies described in 68 publications were identified, often
assessing anxiety disorders (n=9), depressive disorders (n=7), or a combination
of disorders (n=6). Prevalence rates of psychiatric disorders varied widely.
Pooled prevalence estimates of anxiety and depressive disorders were 19% and 13%
prior to TBI, and 21% and 17% in the first year after TBI. Pooled prevalence
estimates increased over time, and indicated high long-term prevalence of Axis I
disorders (54%), including anxiety disorders (36%) or depressive disorders (43%).
Females, those without employment, and those with a psychiatric history before
TBI were at higher risk for anxiety and depressive disorders following TBI. We
conclude that a substantial number of patients encounter anxiety and depressive
disorders following TBI, and that these problems persist over time. All
healthcare settings should pay attention to the occurrence of psychiatric
symptoms in the aftermath of TBI to enable early identification and treatment of
these disorders and to enhance the recovery and quality of life of TBI survivors. 

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