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Brain Injury Volume 38, 2024 - Issue 3
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Review Article

Cognitive behavioral therapy for managing depressive and anxiety symptoms after brain injury: a meta-analysis

Ujjoyinee Baruaa Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada;b St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada;c Faculty of Health Sciences, University of Western Ontario, London, Ontario, CanadaORCID Iconhttps://orcid.org/0000-0003-4958-4644View further author information
ORCID Icon,
Jessica Ahrensa Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada;b St. Joseph’s Health Care, Parkwood Institute, London, Ontario, CanadaView further author information
,
Richard Shaoa Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada;b St. Joseph’s Health Care, Parkwood Institute, London, Ontario, CanadaView further author information
,
Heather MacKenziea Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada;b St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada;d Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, CanadaView further author information
,
Dalton Wolfea Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada;b St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada;c Faculty of Health Sciences, University of Western Ontario, London, Ontario, CanadaView further author information
,
Keith Sequeiraa Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada;b St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada;d Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, CanadaView further author information
,
Robert Teasella Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada;b St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada;d Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, CanadaView further author information
,
Eldon Loha Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada;b St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada;d Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, CanadaView further author information
&
Swati Mehtaa Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada;b St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada;d Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, CanadaCorrespondence[email protected]
View further author information
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Pages 227-240 | Received 15 May 2022, Accepted 19 Jan 2024, Published online: 06 Feb 2024
 
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ABSTRACT

Background

Individuals with traumatic brain injury (TBI) are at increased risk of depression and anxiety, leading to impaired recovery. While cognitive-behavioral therapy (CBT) addresses anxiety and depression maintenance factors, its efficacy among those with TBI has not been clearly demonstrated. This review aims to bridge this gap in the literature.

Methods

Several databases, including Medline, PsycInfo and EMBASE, were used to identify studies published between 1990 and 2021. Studies were included if: (1) trials were randomized controlled trials (RCT) involving CBT-based intervention targeting anxiety and/or depression; (2) participants experienced brain injury at least 3-months previous; (3) participants were ≥18 years old. An SMD ± SE, 95% CI and heterogeneity were calculated for each outcome.

Results

Thirteen RCTs were included in this meta-analysis. The pooled-sample analyses suggest that CBT interventions had small immediate post-treatment effects on reducing depression (SMD ± SE: 0.391 ± 0.126, p < 0.005) and anxiety (SMD ± SE: 0.247 ± 0.081, p < 0.005). Effects were sustained at a 3-months follow-up for depression. A larger effect for CBT was seen when compared with supportive therapy than control. Another sub-analysis found that individualized CBT resulted in a slightly higher effect compared to group-based CBT.

Conclusion

This meta-analysis provides substantial evidence for CBT in managing anxiety and depression post-TBI.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02699052.2024.2309264

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The author(s) reported there is no funding associated with the work article.

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