A systematic literature review of psychotherapeutic treatment of prolonged symptoms after mild traumatic brain injury.

BACKGROUND: Mild traumatic brain injuries (mTBI) are the most common of traumatic brain injuries and patients often experience a wide range of symptoms such as headache, fatigue, dizziness, sleep problems and subjective cognitive deficits. While most symptomatic patients recover quickly, a sub-group of ~ 10-20% of patients experience prolonged symptoms. There is currently a lack of evidence-based treatment for these patients.

OBJECTIVE: The objective of the present paper was to conduct a systematic review of the literature on psychotherapeutic interventions specifically for patients with prolonged symptoms (> 3 months after injury) after mTBI.

METHODS: With a more precise definition of psychotherapy than previous reviews, an extensive literature search was conducted that yielded 2332 hits, of which five were considered to meet the criteria. Only two of the studies were randomized controlled trials.

RESULTS AND CONCLUSIONS: Results revealed several methodological limitations in the included studies, leading to the conclusion that it is premature to make any strong recommendations on psychotherapeutic treatment of prolonged symptoms after mTBI. With in-depth methodological analyses of the included studies and comprehensive recommendations for future research, the present review aims to inform clinicians and to encourage scientists to engage in collaborative effort towards increasing the number of methodologically sound clinical trials in the field.