Ogonah Maya G T, Botchway Stella, Yu Rongqin, Schofield Peter W, Fazel Seena
Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales Australia.
Nat Ment Health. 2025;3(1):83-91. doi: 10.1038/s44220-024-00356-5. Epub 2025 Jan 3.
While numerous reviews have assessed the association between traumatic brain injury (TBI) and various mental and physical health outcomes, a comprehensive evaluation of the scope, validity, and quality of evidence is lacking. Here we present an umbrella review of a wide range of health outcomes following TBI and outline outcome risks across subpopulations. On 17 May 2023, we searched Embase, Medline, Global Health, PsycINFO, and Cochrane Database of Systematic Reviews for systematic reviews and meta-analyses. We compared risk ratios across different outcomes for risks compared with people without TBI and examined study quality, including heterogeneity, publication bias, and prediction intervals. The study was registered with PROSPERO (CRD42023432255). We identified 24 systematic reviews and meta-analyses covering 24 health outcomes in 31,397,958 participants. The current evidence base indicates an increased risk of multiple mental and physical health outcomes, including psychotic disorders, attention-deficit/hyperactivity disorder, suicide, and depression. Three outcomes-dementia, violence perpetration, and amyotrophic lateral sclerosis-had meta-analytical evidence of at least moderate quality, which suggest targets for more personalized assessment. Health-care services should review how to prevent adverse long-term outcomes in TBI.
虽然众多综述评估了创伤性脑损伤(TBI)与各种身心健康结果之间的关联,但缺乏对证据范围、有效性和质量的全面评估。在此,我们对TBI后的广泛健康结果进行了一项综合综述,并概述了不同亚人群的结果风险。2023年5月17日,我们在Embase、Medline、Global Health、PsycINFO和Cochrane系统评价数据库中检索了系统评价和荟萃分析。我们比较了与无TBI者相比,不同结果的风险比,并检查了研究质量,包括异质性、发表偏倚和预测区间。该研究已在PROSPERO(CRD42023432255)注册。我们确定了24项系统评价和荟萃分析,涵盖31397958名参与者的24项健康结果。目前的证据基础表明,多种身心健康结果的风险增加,包括精神障碍、注意力缺陷多动障碍、自杀和抑郁症。痴呆症、暴力行为和肌萎缩侧索硬化症这三项结果有至少中等质量的荟萃分析证据,这表明可作为更个性化评估的目标。医疗服务机构应审视如何预防TBI的不良长期后果。