Treatment for depression following mild traumatic brain injury in adults: A meta-analysis

Primary objective: Development of depression after TBI is linked to poorer outcomes. The aim of this manuscript is to review evidence for the effectiveness of current treatments. Research design: Two meta-analyses were undertaken to examine the effectiveness of both pharmacological and non-pharmacological interventions for depression after mild TBI Method and procedures: PubMed, Medline, PsychInfo, Web of Science and Digital Dissertations were searched and 13 studies located. Meta Analyst Beta 3.13 was used to conduct analyses of pre- vs post-effects then to examine treatment group vs control group effects. Main outcomes and results: Studies using a pre-post design produced an overall effect size of 1.89 (95% CI = 1.20-2.58, p<0.001), suggesting that treatments were effective; however, the overall effect for controlled trials was 0.46 (95% CI = -0.44-1.36, p<0.001), which favoured the control rather than treatment groups. Conclusions: This study highlights the need for additional large well-controlled trials of effective treatments for depression post-TBI.