The Effectiveness of Cognitive Behavioral Therapy for Depression among Individuals with Acquired Brain Injury

Over the years, depression has become a global health concern and a large contributor to the global burden of disease. Depression is now a leading cause of disability worldwide, with current estimates of ova 264 million people of all ages. Cognitive behavioral therapy (CBT) is an evidence-based psychological intervention that is effective for depression. The likelihood of major depression in brain injury patients is up to 8 times higher than that in the general population. Despite this alarming statistic, well-designed, evidence-based research on CBT as a depression intervention for this group lags behind. Gender difference in depression normally found in the general population are also not well-understood among brain injury patients. The current systematic review and men-analysis aimed to address these gaps in the literature. 778 articles were retrieved from four databases (EMBAO, Medline, PsyclNFO and PubMed), and after careful review, eight articles were included in the final meth-analysis for the effectiveness of CBT at post-intervention and three articles were included in the final meta-analysis for the effectiveness of CBT at follow-up. At post-intervention, rest were statistically significant and in awe of CBT for treating depression (SMD = 0.48, p = 0.001). However, these effects were not maintained long-term in follow-ups of 3 to 6 months post-intervention (SMD = 0.11, p = 0.46). To assess for gender differences, 29,941 articles were retrieved from the aforementioned databases, and 15 articles were included in the final meta-analysis. There were significant gender differences in developing depression after brain injury (OR = 1.27, p < 0.001), with the odds being 27% higher in women than in men. Although CBT shows promise in treating depression after brain injury, at least in the short-term, most of the current studies have a high risk of bias, so results should be interpreted with caution. More research on the correlates of depression such as gender will also be useful for the early identification, proper management and access to resources for depression based on risk factors.