Abstract
BackgroundOf the over 1 million reported cases of traumatic brain injuries reported annually in the USA, a sizeable proportion are characterized as mild. Although it is generally well-accepted that most people who suffer a mild traumatic brain injury recover within 1 to 3 months, a proportion of individuals continue to experience physiological, psychological, and emotional symptoms beyond the expected window of recovery. Depression is commonly reported following mild traumatic brain injury; however, its course, consequences, and prognostic factors remain to be well understood.MethodsA systematic review will be conducted of available prospective longitudinal studies of adult mild traumatic brain injury-related depression. The aim of the systematic review is to describe the course of mild traumatic brain injury-related depression, along with its prognostic factors and health consequences. The review will comply with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A thorough database search of peer-reviewed publications in English and French will be conducted in PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Embase, Scopus, Erudit, and Cairn. Independent investigators will perform study selection and data extraction. Risk of bias will be assessed using the Quality in Prognosis Studies tool, and methodological quality will be evaluated using a system inspired by the Scottish Intercollegiate Guidelines Network Methodology. Results will be presented through qualitative description and tabulation.DiscussionThis will be the first systematic review conducted with the aim of describing the course, prognostic factors, and health-related outcomes of depression in adults who have suffered a mild traumatic brain injury. The findings of the planned systematic review have the potential to guide research and clinical practice to effectively develop and implement evidence-based interventions aimed at preventing and alleviating mild traumatic brain injury-related depression.Systematic review registrationPROSPERO CRD42015019214
Highlights
Of the estimated 1.4 million new cases of traumatic brain injury in the USA per year, approximately 85 % are considered mild [1]
There is no universally accepted definition of mild traumatic brain injury, it is usually characterized by a traumatic injury to the head with at least one of the following: loss of consciousness for less
Lepage et al Systematic Reviews (2016) 5:23 about the influence that depression has on health-related outcomes and the rate of recovery from mild traumatic brain injury (mTBI)
Summary
Eligibility criteria Inclusionary criteria To be included in the systematic review, studies must have been peer-reviewed, must be published in English or French, and must have investigated depression in adult patients (>18 years of age) reported to have sustained an mTBI. To report on the health outcomes of mTBI-related depression, the negative effects associated with depression after mTBI (i.e., quality of life, mortality, costs, etc.) at each time-point will be evaluated in the same way as prognostic factors. Studies that did not control for pre-existing depression or did not report on pre-mTBI depression will be rated as “not meeting the criteria.”. Studies without a comparison group (e.g., case studies) will be rated as “not meeting criteria.” (4) Use of a valid, reliable, and responsive measure of mTBI: Studies with a clear definition of mTBI and the same measures across participants (e.g., physician rated Glasgow Coma Scale) will be rated as having “met the criteria.”. (5) Use of valid, reliable, and responsive measure of depression: Studies that included a clear definition of depression and used the same measure of depression across participants will be rated as having “met the criteria.”. We anticipate—due to the heterogeneity in the definition and assessment of depression in the mTBI literature—a meta-analysis will not be feasible; a final determination will be made once all study data have been extracted
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