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Abstract
<h3>Objective(s)</h3> Individuals with traumatic brain injury are highly susceptible to depression and anxiety post-injury, leading to a decreased recovery rate. Cognitive behavioural therapy (CBT) is an evidence treatment for addressing anxiety and depression maintenance factors. However, its' efficacy among those with brain injury lacks a unifying review. Thus, the objective is to evaluate the efficacy of CBT on anxiety and depression among the brain injury population. <h3>Data Sources</h3> Several databases, including Medline, PsycInfo and EMBASE, were used to locate studies published between 1990 and 2020. <h3>Study Selection</h3> Keywords included brain injury and cognitive behaviour therapy. Studies were included if: (1) Trials were randomized controlled trials involving CBT-based intervention targeting anxiety and/or depression; (2) participants experienced a brain injury at least three months previous; (3) participants were at least 18 years of age. <h3>Data Extraction</h3> Study selection articles were reviewed by 2 independent reviewers. Only those articles available in English were retrieved. Articles without sufficient reporting detail to enable the pooling of data were excluded. Risk of bias analysis was conducted using the Cochrane Risk of Bias tool. <h3>Data Synthesis</h3> From the 852 articles, 13 RCTs were included in the final meta-analysis. The pooled analysis suggested that the CBT interventions had small effects on reducing overall depression (SMD±SE: 0.303±0.07, p < .001) and anxiety (SMD±SE: 0.181±0.08, p < .05). Effects increased at 3-month follow-up for depression (SMD: 0.495 (p ˂ .05). A higher effect for CBT interventions was seen for studies that used control (SMD±SE: 0.311±0.07, p < .001) than supportive therapy (SMD±SE: 0.250±0.21, p>.05) as a comparator. <h3>Conclusions</h3> This meta-analysis provides substantial evidence for the use of cognitive behavioural therapy interventions to manage post-brain injury anxiety and depression. <h3>Author(s) Disclosures</h3> No conflict between any of the authors
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