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Appears in Collections:Psychology Journal Articles
Peer Review Status: Refereed
Title: Post-traumatic stress disorder after civilian traumatic brain injury: a systematic review and meta-analysis of prevalence rates
Author(s): Van Praag, Dominique L G
Cnossen, Maryse
Polinder, Suzanne
Wilson, Lindsay
Maas, Andrew
Keywords: civilian
post-traumatic stress disorder
systematic review
traumatic brain injury
Issue Date: Dec-2019
Citation: Van Praag DLG, Cnossen M, Polinder S, Wilson L & Maas A (2019) Post-traumatic stress disorder after civilian traumatic brain injury: a systematic review and meta-analysis of prevalence rates. Journal of Neurotrauma, 36 (23), pp. 3220-3232.
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-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 (from 2.6% to 36%) with a pooled prevalence rate of 15.6%. Pooled prevalence rates of PTSD for mild TBI (13.5%, 95%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 to 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 (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.
DOI Link: 10.1089/neu.2018.5759
Rights: Copyright Dominique L.G. Van Praag et al., 2019; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
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