The association between female sex and depression following traumatic brain injury: A systematic review and meta-analysis

• Published in: Neuroscience and biobehavioral reviews Vol. 168; p. 105952
• Main Authors: Sandhu, Mani Ratnesh S., Schonwald, Antonia, Boyko, Matthew, Jafar, Tamara D., Freedman, Isaac G., Woeste, John, Kurup, Anirudh, Funaro, Melissa C., Zlotnik, Alexander, Gruenbaum, Shaun E., Elsamadicy, Aladine A., Reynolds, Rebecca A., Gruenbaum, Benjamin F.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.01.2025
• Subjects: Brain Injuries, Traumatic - complications; Concussion; Depression; Depression - etiology; Female; Gender; Humans; Male; Sex Characteristics; Sex Factors; TBI; Traumatic brain injury; Depression; Female; TBI; Traumatic brain injury; Gender; Concussion
• ISSN: 0149-7634; 1873-7528; 1873-7528
• DOI: 10.1016/j.neubiorev.2024.105952

While women tend to experience more severe psychiatric and neurobehavioral symptoms following traumatic brain injury (TBI), the connection between sex and post-TBI depression remains poorly understood. To explore the potential association between sex and post-TBI depression, we conducted a systematic review and meta-analysis, including studies with participants who had no prior diagnosis of depression. Thirteen studies met the criteria for inclusion, collectively investigating a cohort of 449,471 individuals with TBI. The median age of the subjects was 49.9 years (≥7 years old). All participants were observed across a spectrum of TBI severities, encompassing mild, moderate, and severe cases. A pooled analysis of 449,471 subjects, revealed a statistically significant difference in the risk of developing post-TBI depression between male and female patients, with females at a significantly higher risk compared to males (RR = 1.4 [95 % CI, 1.29–1.52], P <.0001; I2 = 90.8 %, P <.0001). This significance also appeared in mild TBI/concussion cases (RR = 1.44 [95% CI, 1.36−1.52], P < .0001; I2 = 0%, P = .9), and in depression after a longer period (≥ 24 months) following the TBI (RR = 1.6 [95% CI, 1.59−1.66], P < .0001; I2 = 0%, P = 1). These findings identify TBI as a consistent risk factor for depression, regardless of its severity or type. •Depression is a common neuropsychiatric sequalae following traumatic brain injury (TBI), regardless of its severity or type.•Women exhibit a 1.4-fold increased risk of developing depression following TBI compared to males.•The risk of depression after TBI persists over a longer duration after the initial injury.