Loignon Alexandra, Ouellet Marie-Christine, Belleville Geneviève
École de Psychologie, Université Laval, Quebec, Canada (Ms Loignon and Drs Ouellet and Belleville); and Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Quebec, Canada (Dr Ouellet).
J Head Trauma Rehabil. 2020 Jan/Feb;35(1):E21-E35. doi: 10.1097/HTR.0000000000000514.
To determine whether persons with traumatic brain injury (TBI) are at greater risk of developing posttraumatic stress disorder (PTSD) than other trauma-exposed populations without TBI, and whether this risk is even greater in military/veteran settings than in civilian settings.
A systematic review and meta-analysis was conducted in 7 databases. Reference lists from the 33 identified studies and other relevant reviews were also searched.
The pooled PTSD proportion reached 27% (95% confidence interval = 21.8-33.1) in groups with TBI, which was 2.68 times greater than the observed 11% (95% confidence interval = 8.0-15.0) in groups without TBI. PTSD after TBI was more frequently observed in military samples than in civilians (37% vs 16%). Military and civilian samples were respectively 4.18 and 1.26 times more inclined to have a diagnosis of PTSD after TBI than when there was no TBI. The proportion of PTSD after TBI was concurrently attributable to the methods of the included studies (objectives focused on PTSD diagnosis, type of comparison group) and to characteristics specific to the military setting (country, sex, blast injuries).
TBI diagnosis and military setting represent greater risks for PTSD. The dual diagnosis of TBI and PTSD requires interdisciplinary collaboration, as physical and psychological traumas are closely intertwined.
确定创伤性脑损伤（TBI）患者相比于其他未患TBI的创伤暴露人群，发生创伤后应激障碍（PTSD）的风险是否更高，以及在军事/退伍军人环境中这一风险是否比在 civilian 环境中更高。
在7个数据库中进行了系统评价和荟萃分析。还检索了33项已识别研究的参考文献列表和其他相关综述。
TBI组的PTSD合并比例达到27%（95%置信区间=21.8 - 33.1），这比未患TBI组观察到的11%（95%置信区间=8.0 - 15.0）高2.68倍。TBI后PTSD在军事样本中比在 civilian 样本中更频繁地被观察到（37%对16%）。与无TBI时相比，军事和 civilian 样本在TBI后被诊断为PTSD的倾向分别高4.18倍和1.26倍。TBI后PTSD的比例同时归因于纳入研究的方法（关注PTSD诊断的目标、对照组类型）以及军事环境特有的特征（国家、性别、爆炸伤）。
TBI诊断和军事环境代表了PTSD的更高风险。TBI和PTSD的双重诊断需要跨学科合作，因为身体和心理创伤紧密交织。
