Research Reports - Prevalence of and risk factors for anxiety and depressive disorders after Traumatic Brain Injury

J Neurotrauma. 2016 Apr 29. [Epub ahead of print]

Scholten AC(1), Haagsma JA(1), Cnossen MC(1), Olff M(2), van Beeck EF(1),
Polinder S(1).

This review examined pre- and post-injury prevalence of, and risk factors for,
anxiety disorders and depressive disorders after 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% before
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 after TBI. We conclude that a
substantial number of patients encounter anxiety and depressive disorders after
TBI, and that these problems persist over time. All health care 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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