Authors | Participants | Intervention | Outcome measures | Main results (SD) |
Relander et al11 | Hospital admissions following cerebral concussion |
| Time in bed in hospital; time in hospital; time off work |
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Hinkle et al12 | Minor head injury admitted for 24 h observation |
| Days before return to work or social activity | No difference between three groups but those in the two treatment groups returned to work 1 week earlier than Routine Care group |
Alves et al13 | Hospital admissions mild uncomplicated head injury |
| Postconcussion symptoms (relative risk of being symptomatic at follow-up) | No significant difference between groups |
Mittenberg et al14 | Consecutive hospital admissions after mild head trauma, GCS 13–15 and no PTA | 10-page manual and one session CBT; routine care and discharge information for control group | Frequency (number of PCS symptoms), intensity (scale of 1–10) and duration (days) 6 months after discharge | CBT group significantly reduced frequency (mean 3.10 (3.19) to 1.62 (2.04)), intensity (mean 1.72 (1.93) to 0.80 (1.13)) and duration (mean 51.19 (45.10) to 33.18 (35.62)) of symptoms |
Wade et al15 | A&E attendances and hospital admissions for head injury of any severity | Early intervention, information, advice, further intervention as required (including CBT) (n=252); standard care (n=226) | RPQ RHFUQ | No difference between groups; subgroup analysis suggested some benefit for those with moderate or severe injury |
Paniak et al16 | Volunteers with MTBI from consecutive admissions to emergency department |
| Problem Checklist Community Integration Questionnaire SF-36 | Both groups improved; no significant difference |
Wade et al17 | Hospital admissions for head injury of any severity | Early intervention, information, advice, further intervention as required (including CBT) (n=132); standard care (n=86) |
| Significant difference in RPQ mean 9.8 (11.7) (trial) vs 13.9 (13.6) (conrol); RHFUQ mean 5.36 (7.81) (trial) vs 8.23 (8.75) (control) |
Paniak et al18 | Volunteers with MTBI from consecutive admissions to emergency department at 1 year follow-up |
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| Both groups improved, no significant difference; improvements at 3 months maintained at 12 months |
Hanna-Pladdy et al19 | Undergraduate students screened for history of MTBI and PCS symptoms |
| Physiological measures; neuropsychological measures; self-reported measures (postconcussion symptoms and stress) | Postconcussion symptoms increase with stress in symptomatic groups regardless of history of injury, effects decreased with relaxation; no difference in symptom reporting between MTBI and uninjured |
McMillan et al20 | Neurosurgical patients with traumatic brain injury with attentional problems on neuropsychological testing |
| Cognitive function (objective + self report); HADS; General Health Questionnaire, RPQ | No significant differences between the three groups on these measures post-treatment or 6 or 12 months follow-up |
Ponsford et al21 | Discharges from emergency department after mild head injury |
| SCL-90-R HRSRE (stress) PCS Checklist Neuropsychological measures | No means or SD reported. Improved sleep (p=0.01) and anxiety (p=0.04) No difference in neuropsychological measures |
Rath et al22 | High-functioning TBI (various severity) outpatients attending a neuropsychological rehabilitation programme with variety of postconcussion complaints |
| Measures of cognitive skills, psychosocial functioning, problem-solving and significant-other reports | Both groups improved; inconclusive |
Hodgson et al23 | Referrals from local brain injury units and community services |
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Tiersky et al24 | Recruitment of subjects with mild–moderate TBI | CBT and cognitive remediation (50 min each, 3T per week for 11 weeks) versus waiting list control | SCL-90R PASAT CRI (problem solving) Attention questionnaire | Significant improvement SCL-90R, mean 8.06 (0.41) vs 1.71 (1.00); depression subscale, mean 1.12 (0.45) to 2.11 (1.14); anxiety subscale, mean 0.72 (0.42) vs 1.53 (1.02) and PASAT 135.55 (30.71) vs 110.88 (60.28). No difference in CRI or attention |
Ghaffer et al25 | Consecutive presenters to emergency department with mild TBI |
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| No significant treatment effects, except in improvement of depression in those with past psychiatric history (no means reported, p=0.01) |
Elgmark Andersson et al26 | Selected subjects from patients diagnosed as having MTBI in emergency department | Reassurance, information, telephone contact and outpatient reviews plus specialist referral as needed (n=246) Treatment as usual (n=109) | PCS questionnaire Life Satisfaction questionnaire CIQ SF-36 | No difference other than improvement in one aspect of life satisfaction (physical health) |
Ownsworth et al27 | Acquired brain injury, various aetiology, convenience sample attending outpatient brain injury units |
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BAI, Beck Anxiety Inventory; BDI, Beck Depression Inventory; BDI-I, Beck Depression Inventory II; CIQ, Community Integration Questionnaire; CES-D, Centre for Epidemiological Studies-Depression; CRI, Coping Response Inventory GHQ, General Health Questionnaire; GCS, Glasgow Coma Scale; HADS, Hospital Anxiety and Depression Scale; HRSRE, Holmes Rahe survey of recent experiences; MOCI, Maudsley Obsessive–compulsive Inventory; MHLC, Multidimensional Health Locus of Control Scale; MTBI, Mild traumatic brain injury; PASAT, Paced auditory serial addition task; PCS, postconcussive syndrome; PSS, Perceived Stress Scale; PTA, Post-Traumatic amnesia; RHFUQ, Rivermead head injury follow-up questionnaire; RPQ, Rivermead Postconcussion symptoms questionnaire; SF36, Medical Outcome Study 36-item Short-Form Health Survey; SCL-90-R, Symptom checklist 90 revised; TBI, Traumatic brain injury.