Characteristics of included studies
| Study | Diagnosis | Head injury severity | MDD | Study design | Comparison | Patients, n | Duration, w | Outcome* | Mean age ± SD, yr | Female, % | Dropout rate, % | Country |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pharmacologic interventions | ||||||||||||
| Ansari et al. (25) | TBI | Mild to moderate | Yes | RCT | Sertraline 50 mg/d Placebo | 40 40 | 24 | PHQ-9 (+) | > 18 | 0 | NA | India |
| Ashman et al. (1) | TBI MDD | NA | Yes | RCT | Sertraline 25–200 mg/d Placebo | 22 19 | 10 | HAM-D (−) | 49.1 ± 10.9 | 41.5 | NA | Australia |
| Fann et al. (26) | TBI MDD | NA | Yes | RCT | Sertraline 25–200 mg/d Placebo | 31 31 | 12 | HAM-D (−) | 37.5 ± 12.5 | 24.2 | 32.0 10.0 | United States |
| Grima et al. (27) | TBI Insomnia | Mild to severe | NA | RCT (crossover) | Melatonin 2 mg/d Placebo | 18 15 | 4 | HADS-D (−) | 37 ± 11 | 33.3 | 0.0 8.6 | Australia |
| Lee et al. (28) | TBI MDD | Mild to moderate | Yes | RCT | Methylphenidate 20 mg/d Sertraline 100 mg/d Placebo | 10 10 10 | 4 | HAM-D (+) HAM-D (+) | 35.3 ± 8.0 33.6 ± 12.3 35.5 ± 7.2 | 20 | NA | Korea |
| Novack et al. (29) | TBI | Moderate to severe | No | RCT | Sertraline 50 mg/d Placebo | 49 50 | 12 | NFI-D (+) | 35.3 ± 16.7 34.5 ± 15.6 | 27.3 | 40.8 24.0 | United States |
| Rao (30) | TBI MDD | NA | Yes | RCT | Escitalopram 10–20 mg/d Placebo | 7 6 | 12 | MADRS | NA | 35.7 | 11.4 0.0 | United States |
| Ripley et al. (31) | TBI Attention problems | Moderate to severe | NA | RCT (crossover) | Atomoxetine 80 mg/d Placebo | 26 29 | 2 | NFI-D (−) | 40.6 ± 11.8 | 25.5 | 3.9 6.9 | United States |
| Wroblewski et al. (32) | TBI MDD | Severe | Yes | RCT | Despiramine 150 mg/d Placebo | 6 4 | 4 | Affect/Mood scale (−) | 32.2 ± 8.51 | 30 | NA | United States |
| Zhang et al. (33) | TBI MDD | Mild to moderate | Yes | RCT | Methylphenidate 20 mg/d Placebo | 18 18 | 30 | BDI (+) | 36.3 ± 10.9 34.9 ± 12.1 | 25 | 5.6 11.1 | China |
| Nonpharmacologic interventions | ||||||||||||
| Andrewes et al. (34) | TBI | NA | NA | RCT | Positive psychology interventions CBT | 5 5 | 12 | AHI (+) | 38.3 ± 5.9 46.0 ± 11.1 | 10 | 20.0 0.0 | United Kingdom |
| Ashman et al. (35) | TBI MDD | NA | Yes | RCT | CBT Supportive psychotherapy | 39 38 | 12 | BDI (−) | 47.1 ± 10.6 48.1 ± 10.2 | 54.5 | 43.6 44.8 | United States |
| Bedard et al. (36) | TBI MDD | NA | Yes | RCT | Mindfulness-based cognitive therapy Usual care | 38 38 | 10 | BDI (+) | 46.8 ± 13.4 | 44.7 | 33.3 20.8 | Canada |
| Bell et al. (37) | TBI | Mild | NA | RCT | Telephone problem- solving Usual care | 178 178 | 24 | PHQ-9 (−) | 29.4 ± 7.2 | 6.74 | 22.0 17.0 | United States |
| Bellon et al. (38) | TBI | NA | NA | RCT (crossover) | Walking program Nutrition program | 28 29 | 12 | CES-D (−) | 43.7 ± 15.8 | 41 | 0.0 0.0 | United States |
| Bombardier et al. (39) | TBI | Mild to severe | NA | RCT | Telephone supportive psychotherapy Usual care | 62 64 | 36 | NFI-D (+) | 34.5 ± 13.9 37.1 ± 15.6 | 25.4 | 27.0 25.6 | United States |
| Driver et al. (40) | TBI Cognitive impairment | NA | NA | RCT | Walking program Vocational rehabilitation class | 8 8 | 8 | POMS-D (−) | 38.8 ± 2.5 40.8 ± 14.7 | NA | 0.0 0.0 | United States |
| Fann et al. (41) | TBI MDD | Mild to severe | Yes | RCT | CBT Telephone CBT Usual care | 18 40 42 | 16 | HAMD-17 (−) | 45.8 ± 13.3 | 37 | 17.0 7.0 14.0 | United States |
| McDonald et (42) | TBI | Severe | No | RCT | Social skills training Social group Usual care | 18 17 16 | 12 | DASS-D (−) | 36.3 ± 10.7 33.1 ± 11.7 35.2 ± 11.3 | 21.6 | 22.2 23.5 25.0 | |
| Nguyen et al. (43) | TBI Poor sleep | Mild to severe | NA | RCT | CBT Usual care | 13 11 | 8 | HADS-D (+) | 43.9 ± 13.0 | 33.3 | 15.3 9.1 | Australia |
| Ponsford et al. (44) | TBI Anxiety or depressive symptoms | Mild to severe | NA | RCT | CBT (+ non-directive supportive counselling) Motivational interviewing + CBT Usual care | 26 26 23 | 12 | DASS-D (+) | 42.2 ± 14.5 | 26.7 | 15.3 15.4 8.7 | Australia |
| Potter et al. (45) | TBI | NA | NA | RCT | CBT Usual care | 26 20 | 12 | HADS-D | 41.4 ± 11.6 | 45.6 | 3.8 0.0 | United Kingdom |
| Simpson et al. (46) | TBI Suicidal ideation or hopelessness | Severe | NA | RCT | Group-based CBT Usual care | 8 9 | 10 | HADS-D (−) | 39.4 ± 12.4 44.1 ± 11.7 | NA | 0.0 11.1 | Australia |
| Storzbach et al. (47) | TBI | Mild | NA | RCT | Compensatory cognitive training Usual care | 50 69 | 10 | BDI (−) | 35.4 ± 8.4 34.8 ± 7.4 | 5.0 | 28.0 26.0 | United States |
| Struchen et al. (48) | TBI | NA | NA | RCT | Social training Usual care | 12 18 | 12 | CES-D (x) | NA | NA | 50.0 14.3 | United States |
| Tiersky et al. (49) | TBI Cognitive dysfunction Emotional distress | Mild to moderate | NA | RCT | CBT Usual care | 11 9 | 11 | SCL-90R (+) | 46.9 ± 10.5 | 55 | 21.4 40.0 | United States |
| Twamley et al. (50) | TBI | Mild to moderate | NA | RCT | CogSMART + supported employment Enhanced supported employment | 16 18 | 12 | HAM-D (−) | 29.4 ± 6.2 34.3 ± 7.4 | 5.9 | 12.5 5.6 | United States |
AHI = Authentic Happiness Inventory; BDI = Beck Depression Inventory; CBT = cognitive behavioural therapy; CES-D = Center for Epidemiological Studies–Depression; CogSMART = Cognitive Symptom Management and Rehabilitation Therapy; DASS-D = Depression and Anxiety Stress Scale–Depression; HADS-D = Hospital Anxiety and Depression Scale, Depression subscale; HAM-D = Hamilton Depression Rating Scale; HAMD-17 = Hamilton Depression Rating Scale, 17 items; MADRS = Montgomery–Åsberg Depression Rating Scale; MDD = major depressive disorder; NA = not available; NFI-D = Neurobehavioral Functioning Inventory–Depression; PHQ-9 = Patient Health Questionnaire-9; POMS-D = Profile of Mood States–Depression; RCT = randomized controlled trial; SCL-90R = Symptom Checklist 90–Revised; TBI = traumatic brain injury.
↵* (+) = intervention group significantly better than control group; (−) = no significant difference between intervention group and control group; (x) = intervention group significantly worse than control group.