Post-Traumatic Stress Disorder after Civilian Traumatic Brain Injury: A Systematic Review and Meta-Analysis of Prevalence Rates

Abstract

Post-traumatic stress disorder (PTSD) is a commonly diagnosed psychiatric disorder following traumatic brain injury (TBI). Much research on PTSD and TBI has focused on military conflict settings. Less is known about PTSD in civilian TBI. We conducted a systematic review and meta-analysis on the prevalence of PTSD after mild and moderate/severe TBI in civilian populations. We further aimed to explore the influence of methodological quality and assessment methods.A systematic literature search was performed on studies reporting on PTSD in civilian TBI, excluding studies on military populations. The risk of bias was assessed using the MORE (Methodological evaluation of Observational REsearch) checklist. Meta-analysis was conducted for overall prevalence rates for PTSD with sensitivity analyses for the severity of TBI.Fifty-two studies were included, of which 31 were graded as low risk of bias. Prevalence rates of PTSD in low risk of bias studies varied widely (2.6–36%) with a pooled prevalence rate of 15.6%. Pooled prevalence rates of PTSD for mild TBI (13.5%, 95% confidence interval [CI]: 11.7–15.3; I2 = 2%) did not differ from moderate/severe TBI (11.8, 95% CI: 7.5–16.1; I2 = 63%). Similar rates were reported in studies using different approaches and times of assessment. Although most studies that compared participants with TBI with trauma patients and healthy controls found no difference in prevalence rates of PTSD, a meta-analysis across studies revealed a higher prevalence of PTSD in patients with TBI (odds ratio [OR]: 1.73, 95% CI: 1.21–2.47).This review highlights variability between studies and emphasizes the need for higher-quality studies. Further research is warranted to determine risk factors for the development of PTSD after TBI.

The Role of BDNF in Experimental and Clinical Traumatic Brain Injury

“…Additionally, psychiatric factors can have consequences for cognitive function. Post-traumatic stress disorder (PTSD) has become increasingly discussed as a possible consequence to TBI [ 34 ], which in return can have an impact on cognitive function. One study reports of an increased prevalence of PTSD among Met+ patients with mTBI [ 24 ].…”

The Association of Post-Concussion and Post-Traumatic Stress Disorder Symptoms with Health-Related Quality of Life, Health Care Use and Return-to-Work after Mild Traumatic Brain Injury

“…Patients may also suffer from symptoms of posttraumatic stress disorder (PTSD) [6,9]. After mild TBI in the civilian setting, approximately 14% have PTSD [10]. These symptoms can be differentiated into four symptom groups: intrusion/re-experiencing, avoidance, negative alterations in cognition and mood, and increased arousal/reactivity.…”

Preliminary validation of the Dutch version of the Posttraumatic stress disorder checklist for DSM-5 (PCL-5) after traumatic brain injury in a civilian population

“…Posttraumatic Stress Disorder (PTSD) is a mental disorder following a traumatic event, expressed by different symptoms such as persistent remembering or reliving the event, trying to avoid specific stressors, difficulty in falling asleep, irritability, hyper-vigilance and others [1]. The topic of PTSD has been widely investigated in patients following a traumatic brain injury (TBI) [2]. TBI forms a large public health and societal problem and over two million people are admitted to hospital each year in Europe [3].…”