Evidence-Based Review of Randomized Controlled Trials of Interventions for Mental Health Management Post-Moderate to Severe Traumatic Brain Injury.
Study Goal
The researchers aimed to evaluate the effectiveness of walking as a nonpharmacological intervention for depression and stress in individuals with moderate to severe traumatic brain injury (post-MSTBI).
Results Summary
Walking was found to be effective for reducing depression and stress in post-MSTBI patients, alongside other nonpharmacological interventions like Tai Chi and dance.
Population
Individuals with moderate to severe traumatic brain injury (post-MSTBI).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
desipramine | decrease | mental health post-MSTBI | participants post-MSTBI | - | Effective pharmacological treatments included | #1 |
cerebrolysin | decrease | mental health post-MSTBI | participants post-MSTBI | - | Effective pharmacological treatments included | #2 |
methylphenidate | no change | mental health post-MSTBI | participants post-MSTBI | - | showed conflicting evidence | #3 |
rivastigmine | no change | mental health post-MSTBI | participants post-MSTBI | - | showed conflicting evidence | #4 |
Cognitive behavioral therapy (CBT) | decrease | hopelessness | participants post-MSTBI | - | was found to be effective for | #5 |
Cognitive behavioral therapy (CBT) | decrease | stress | participants post-MSTBI | - | was found to be effective for | #6 |
Cognitive behavioral therapy (CBT) | decrease | anxiety | participants post-MSTBI | - | was found to be effective for | #7 |
Cognitive behavioral therapy (CBT) | no change | depression | participants post-MSTBI | - | may be as effective as supportive psychotherapy for | #8 |
CBT combined with motivational interviewing | no change | depression | participants post-MSTBI | - | may be as effective as CBT combined with nondirective counseling for | #9 |
CBT combined with motivational interviewing | no change | stress | participants post-MSTBI | - | may be as effective as CBT combined with nondirective counseling for | #10 |
CBT combined with motivational interviewing | no change | anxiety | participants post-MSTBI | - | may be as effective as CBT combined with nondirective counseling for | #11 |
Acceptance and commitment therapy | decrease | anxiety | participants post-MSTBI | - | was effective for | #12 |
Acceptance and commitment therapy | decrease | stress | participants post-MSTBI | - | was effective for | #13 |
Acceptance and commitment therapy | decrease | depression | participants post-MSTBI | - | was effective for | #14 |
Tai Chi | decrease | depression | participants post-MSTBI | - | appeared to be effective for | #15 |
Tai Chi | decrease | stress | participants post-MSTBI | - | appeared to be effective for | #16 |
dance | decrease | depression | participants post-MSTBI | - | appeared to be effective for | #17 |
dance | decrease | stress | participants post-MSTBI | - | appeared to be effective for | #18 |
walking | decrease | depression | participants post-MSTBI | - | appeared to be effective for | #19 |
walking | decrease | stress | participants post-MSTBI | - | appeared to be effective for | #20 |
peer mentoring | no change | mental health post-MSTBI | participants post-MSTBI | - | showed limited effectiveness | #21 |
OBJECTIVE: To present an evidence-based review of randomized controlled trials (RCTs) evaluating interventions for mental health post-moderate to severe traumatic brain injury (post-MSTBI), as part of an extensive database that has been conceptualized as a living systematic review. METHODS: Systematic searches were conducted for RCTs published in the English language in MEDLINE, PubMed, Scopus, CINAHL, EMBASE, and PsycINFO, up to and including December 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The methodological quality of RCTs was assessed using the Physiotherapy Evidence Database scale, and the level of evidence was assigned using a modified Sackett scale. RESULTS: Eighty-seven RCTs examining mental health interventions and outcome measures post-MSTBI were included. These studies collectively enrolled 6471 participants. A total of 41 RCTs (47.1%) were conducted in the United States and 56 studies (64.4%) were published after 2010. A total of 62 RCTs (71.3%) examined nonpharmacological interventions and 25 RCTs (28.7%) examined pharmacological interventions. Effective pharmacological treatments included desipramine and cerebrolysin; methylphenidate and rivastigmine showed conflicting evidence. Cognitive behavioral therapy (CBT) was found to be effective for hopelessness, stress, and anxiety, compared to usual care; however, it may be as effective as supportive psychotherapy for depression. CBT combined with motivational interviewing may be as effective as CBT combined with nondirective counseling for depression, stress, and anxiety. Acceptance and commitment therapy was effective for anxiety, stress, and depression. Tai Chi, dance, and walking appeared to be effective for depression and stress, while other nonpharmacological treatments such as peer mentoring showed limited effectiveness. CONCLUSION: This evidence-based review provides a comprehensive overview of the research landscape of RCTs addressing mental health post-MSTBI. The findings from these RCTs may be valuable for health care professionals, researchers, and policymakers involved in the field of mental health and neurorehabilitation.