Aguda Akinwale, Mavroudis Ioannis
Psychiatry of Learning disability, Health Education Yorkshire and the Humber, Hull, UK.
Department of Neuroscience, Leeds Teaching Hospitals, NHS Trust and Leeds University, Leeds, UK.
Acta Neurol Belg. 2025 Sep 2. doi: 10.1007/s13760-025-02883-z.
Mild traumatic brain injury (mTBI), commonly known as concussion, has historically been regarded as a transient and benign condition. However, recent studies suggest it may increase the risk of long-term psychiatric outcomes, including psychosis. This study aimed to systematically review and meta-analyze the association between mTBI and subsequent risk of psychosis.
A comprehensive search of PubMed, PsycINFO, and Google Scholar was conducted through June 2025. Studies were eligible if they included individuals with a history of mTBI, a non-TBI control group, and reported psychosis-related outcomes with estimable risk measures. Random-effects meta-analysis was performed using the metafor package in R. Risk of bias and publication bias were assessed, and meta-regression was conducted to explore moderators such as adjustment status and effect size type.
Seven studies comprising pediatric and adult populations were included. The pooled risk ratio (RR) for psychosis following mTBI was 1.57 (95% CI: 1.28-1.91, p < 0.001), indicating a statistically significant association. The 95% prediction interval (1.03-2.38) suggests generalizability across future studies. No significant publication bias was detected (Egger's test p = 0.10). Meta-regression found no difference between adjusted and unadjusted estimates (p = 0.802). Sensitivity analyses confirmed the robustness of the findings.
mTBI is associated with a moderate but statistically significant increase in the risk of psychosis. Given the prevalence of mTBI in the general population, these findings highlight the need for long-term psychiatric monitoring and preventive strategies, particularly in youth and high-risk individuals.
轻度创伤性脑损伤（mTBI），通常称为脑震荡，在历史上一直被视为一种短暂的良性病症。然而，最近的研究表明，它可能会增加包括精神病在内的长期精神疾病的风险。本研究旨在系统回顾和荟萃分析mTBI与后续精神病风险之间的关联。
截至2025年6月，对PubMed、PsycINFO和谷歌学术进行了全面检索。如果研究纳入了有mTBI病史的个体、非TBI对照组，并报告了具有可估计风险测量的精神病相关结果，则这些研究符合条件。使用R语言中的metafor包进行随机效应荟萃分析。评估了偏倚风险和发表偏倚，并进行了荟萃回归以探索调节因素，如调整状态和效应大小类型。
纳入了七项包括儿童和成人人群的研究。mTBI后发生精神病的合并风险比（RR）为1.57（95%CI：1.28 - 1.91，p < 0.001），表明存在统计学上的显著关联。95%预测区间（1.03 - 2.38）表明在未来研究中具有普遍性。未检测到显著的发表偏倚（Egger检验p = 0.10）。荟萃回归发现调整后和未调整估计之间没有差异（p = 0.802）。敏感性分析证实了研究结果的稳健性。
mTBI与精神病风险的中度但统计学上显著增加相关。鉴于mTBI在普通人群中的患病率，这些发现凸显了长期精神科监测和预防策略的必要性，特别是在青少年和高危个体中。
