The Frequency of Neuropsychiatric Sequelae After Traumatic Brain Injury in the Global South: A systematic review and meta-analysis

Abstract

This study aimed to assess the prevalence of neuropsychiatric sequelae following traumatic brain injury (TBI) among the Western Asian, South Asian and African regions of the global south. All studies on psychiatric disturbances or cognitive impairment following TBI conducted (until August 2021) in the 83 countries that constitute the aforementioned regions were reviewed; 6 databases were selected for the literature search. After evaluating the articles using the Joanna Briggs Institute guidelines, the random effects model was used to estimate the prevalence of depression, anxiety, post-traumatic stress disorder (PTSD), TBI-related sleep disturbance (TBI-SD), obsessive-compulsive disorder (OCD) and cognitive impairment. Of 56 non-duplicated studies identified in the initial search, 27 were eligible for systematic review and 23 for meta-analysis. The pooled prevalence of depression in 1,882 samples was 35.35%, that of anxiety in 1,211 samples was 28.64%, that of PTSD in 426 samples was 19.94%, that of OCD in 313 samples was 19.48%, that of TBI-SD in 562 samples was 26.67% and that of cognitive impairment in 941 samples was 49.10%. To date, this is the first critical review to examine the spectrum of post-TBI neuropsychiatric sequelae in the specified regions. Although existing studies lack homogeneous data due to variability in the diagnostic tools and outcome measures utilised, the reported prevalence rates are significant and comparable to statistics from the global north.

Keywords: Anxiety; Cognitive Impairment; Depression; Meta-analysis; Neuropsychiatry; Systematic Review; Traumatic Brain Injury.

Figure 1

Prevalence estimates of depression following traumatic brain injury (N= 1,882). Heterogeneity: I ² = 96.20%, Q = 394.96; P <0.001. CI = confidence interval

Figure 2

Prevalence estimates of anxiety following traumatic brain injury (N = 1,211). Heterogeneity: I ² = 94.92%, Q = 196.91; P <0.001. CI = confidence interval.

Figure 3

Prevalence estimates of post-traumatic stress disorder following traumatic brain injury (N = 426). Heterogeneity: I ² = 97.28%, Q = 73.46; P <0.001. CI = confidence interval; PTSD = post-traumatic stress disorder.

Figure 4

Prevalence estimates of obsessive-compulsive disorders following traumatic brain injury (N = 313). Heterogeneity: I ² = 97.84%, Q = 92.44; P <0.001. CI = confidence interval; OCD = obsessive-compulsive disorder.

Figure 5

Prevalence estimates of traumatic brain injury-related sleep disturbance (N = 562). Heterogeneity: I² = 90.27%, Q = 30.83; P <0.001. CI = confidence interval; TBI-SD = traumatic brain injury-related sleep disturbance.

Figure 6

Prevalence estimates of cognitive impairment following traumatic brain injury (N = 941). Heterogeneity: I² = 96.85%, Q = 222.41; P <0.001. CI = confidence interval.