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Neuropsychological rehabilitation and psychotherapy of adult traumatic brain injury patients with depression: a systematic review and meta-analysis.

Abstract
There is still insufficient appreciation whether neuropsychological rehabilitation and psychotherapy are effective in attenuating depression following traumatic brain injury (TBI). This knowledge gap was addressed in the present systematic review and meta- analysis of the literature. We conducted electronic database (Medline, PsychINFO, Scopus) searches (time frame: January 1, 2005 - December 31, 2015) for clinical studies that had tested neuropsychological rehabilitation and psychotherapy in adult TBI survivors with depression. The studies were to have experimental or quasi-experimental study design, and to include survivors from non-military TBI. Quantitative assessment of qualifying studies was done using the random effects model. We calculated the pooled size effect using standardized mean difference (SMD) as the main effect measure. We identified three studies, totalling 231 participants, which tested cognitive behavioural therapy or mindfulness-based cognitive therapy as interventions to attenuate post-TBI depression. The analysis revealed a small and non-significant decrease in depression symptoms due to intervention (SMD = -0.23 [95% confidence interval: -050, 0.03; z=1.73, p=0.08]). Testing for publication bias was not feasible due to low number of identified studies. Current evidence indicates only a small therapeutic effect of psychotherapy in attenuating post-TBI depression.

PMID: 28322535 [Pubmed - Publisher]

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