The Development of Posttraumatic Stress Disorder after Mild Traumatic Brain Injury in Civilian Populations: A Meta-Analysis
|Xi Han1, Ping Sheng2,3*, Chengguang Huang2, Mingkun Yu2, Lijun Hou2 and Yan Dong2,3*|
|1Department of Neurosurgery, Huashan Hospital, Fudan University, China|
|2Department of Neurosurgery, Second Military Medical University, China|
|3Neuroscience center, Second Military Medical University, China|
|Corresponding Author :||Yan Dong
Department of Neurosurgery, Shanghai Institute of Neurosurgery
Military Institute of Neurosurgery, Changzheng Hospital
Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China
E-mail: [email protected] or [email protected]
|Received February 24, 2014; Accepted April 23, 2014; Published April 25, 2014|
|Citation: Han X, Sheng P, Huang C, Yu M, Hou L, et al. (2014) The Development of Posttraumatic Stress Disorder after Mild Traumatic Brain Injury in Civilian Populations: A Meta-Analysis. J Sleep Disord Ther 3:164. doi:10.4172/2167-0277.1000164|
|Copyright: © 2014 Han X, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Background: Posttraumatic stress disorder (PTSD) is an anxiety disorder following exposure to a traumatic
event. Recent studies demonstrate that mild traumatic brain injury (mTBI) is strongly associated with PTSD among
soldiers returning from Iraq. However, the effect of mTBI on development of PTSD in civilian populations is quite
controversial. The study is aimed at identifying whether mTBI contributes to an increased risk of PTSD in civilian
populations as it happens in the service members.
Methods: A comprehensive search of literature was undertaken in order to identify published studies on PTSD
associated with mTBI. mTBI was defined according to the American Congress of Rehabilitation Medicine (ACRM).
PTSD was operationalized as the presence of symptoms consistent with those defined by the Diagnostic and
Statistical Manual of Mental Disorders. The effect of mTBI on the development of PTSD was assessed with odds
ratio (OR) with 95% confidence intervals (CIs).
Results: The pooled data consisted of 1222 mTBI patients and 1468 general trauma participants. 14% of mTBI
patients reported PTSD, and 9% of general trauma patients developed PTSD. Or of the pooled studies indicates
a 61% increase in the prevalence of PTSD, suggesting that mTBI might increase the risk of development of PTSD
in civilian settings (or 1.61, 95% CI 1.25-2.06. p=0.0002, I2=0%). The occurrence of PTSD was not significantly
different among 3-months, 6-months and 12-months follow up subgroups (p=0.28). A sensitivity analysis shows the
results are affected by sequential exclusion of study reported by Bryant et al. (2010). When Bryant et al. data were
removed, OR of the other six studies demonstrates that the prevalence of PTSD in mTBI and general trauma groups
doesn’t significantly differ (OR 1.30, 95% CI 0.88-1.93. p=0.19, I2=0%). The study from Bryant et al contributed 57%
of patients to overall data, which was derived from four levels I trauma centers across three states in Australia.
Conclusion: Our data indicate that mTBI patients are more prone to develop PTSD than general trauma patients
without mTBI in civilian settings.