Cognitive behavioral therapy for managing depressive and anxiety symptoms after brain injury: a meta-analysis
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.
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Contrary to previous meta-analyses, anxiety in people with traumatic brain injury did not improve compared with controls, possibly because trials with fewer than 20 participants per group were excluded.
“Contrary to previous meta-analyses (Barua et al., 2024), anxiety in people with TBI did not improve compared to controls, possibly due to our exclusion of trials with fewer than 20 participants per group.”
From Cognitive behavioral interventions for depression and anxiety in adults with neurological disorders: a systematic review and meta-analysis (2024) · cites this paper as Barua et al., 2024
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Self-citationSevere traumatic brain injury: non-military patients’ essential need for behavioural healthcare
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- Authors
- Barua, U., Ahrens, J., Shao, R., MacKenzie, H., Wolfe, D., Sequeira, K., Teasell, R., Loh, E., & Mehta, S.
- Affiliations
- Western University (CA)
- Parkwood Institute (CA)
- Corresponding author
- Mehta, Swati
- ORCID
- Venue
- Brain Injury
- Publisher
- Informa UK Limited
- Published
- 2024-02-06
- Volume
- 38
- Issue
- 3
- Pages
- 227-240
- ISSN
- 0269-9052 (ISSN-L)
- 1362-301X
- OpenAlex
- W4391565880
- Cited by
- 12
- References
- 56
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 3
- FWCI
- 0.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Brain Injury (publishedVersion)
- PubMed (publishedVersion)
- Funders
- thor(s) reported there is no
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- cognitive behavioral therapy, traumatic brain injury, depression, anxiety, post-traumatic depression, post-traumatic anxiety, group cognitive behavioral therapy, treatment efficacy
- MeSH terms
- Adolescent, Adult, Anxiety, Anxiety Disorders, Brain Injuries, Humans, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic
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