Table 1.
Details of Studies Included in the Meta-Analysis of Risk of Psychosis Following Traumatic Brain Injury (TBI)
| Authors | Type of Study | Total N | Sample Description | Source of Information About TBI | Source of Information About Psychosis | Risk Estimate for Psychosis Following TBI, OR (95% CI) |
| Silver10 | Cohort | 5034 | Probability sample of adults from New Haven portion of the NIMH Epidemiologic Catchment Area programme | Patient report of history of severe TBIa (Have you ever had a severe head injury that was associated with loss of consciousness?) Lifetime | NIMH Diagnostic Interview Schedule (diagnosis of schizophrenia) | 1.8 (1.0–3.3)b |
| Malaspina11 | Family | 1931 | National Institute of Mental Genetics Initiative for Schizophrenia and Bipolar Disorders | Patient report- Diagnostic Interview for Genetic Studies question on Head Injurya (combined mild, moderate, and severe) | Diagnostic Interview for Genetic Studies | 3.32 (1.77–6.22)c |
| Nielsen12 | Nested Case-Control | 91 168 | Record linkage sample | Hospital admission register ICD-8 Admission for head injury (concussion and severe head injury) | Danish National Patient Register —diagnosis of schizophrenia | 0.91 (0.84–1.008)d; 0.94 (0.84–1.05) Mild TBI; 0.89 (0.76–1.04) Severe |
| Timonen13 | Cohort | 10 934 | Northern Finland 1966 Birth Cohort Study | Hospital discharge registers and case notes of outpatient clinics (ICD definition) Up to age 15 | Finnish Hospital Discharge Register | 1.1 (0.41–2.96)e |
| Abdel Malik14 | Family | 169 | Ongoing study of familial schizophrenia-genetic linkage of narrowly defined schizophrenia | From SCID-1 and supplemented by collateral information from family and medical records. consesnus rating | Structured Clinical Interview for DSM-III-R (diagnosis of schizophrenia and schizophrenia spectrum disorders) | 2.27 (1.08–4.38)f; 1.91 (0.84–4.38), (broad diagnosis) |
| Massagli15 | Cohort | 1960 | Adult Health Maintenance Organization—Group Health Co-operative of Puget Sound children 14-year old or less | Computerized databases on all inpatient and outpatient visits and diagnoses—info on Mild TBI onlya | Computerized databases on all inpatient and outpatient visits and diagnoses ICD-9 codes | 3.01 (0.9–10.2)g |
| Fann16 | Cohort | 939 | Adult Health Maintenance Organization—Group Health Co-operative of Puget Sound (members 15 years or older) | Computerized databases on all inpatient and outpatient visits and diagnoses (mild, moderate and severe TBIa) | Computerized databases on all inpatient and outpatient visits and diagnoses | 1.8 (1.22–2.77)h; 1.1. (0.4–3.1) mild TBI; 3.6 (1.0–12.3) severe TBI |
| Harrison17 | Nested Case-Control | 47 754 | Record linkage sample of a cohort of Swedish men and women born between January 1973 and December 1980 | Swedish Inpatient Discharge Register (hospital admission for concussion and skull or intracranial injuries) | Swedish Inpatient Discharge Register (schizophrenia and nonaffective psychosis) | 1.10 (0.82–1.47) (narrow definition); 1.27 (1.1–1.47) (broad definition |
| Chen18 | Cohort | 20 970 | Record linkage of 2 datasets in Taiwan (adults aged >18) | TBI Registry (Head and Spinal Cord Injury Research Group of the Taiwan Neurosurgical Society) 2001–2002 | Taiwan National Health Insurance Research Dataset (2001–2002) | 1.99 (1.28–3.08)i |
Note:DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised; NIMH, National Institute of Mental Health; ICD, International Classification of Diseases; SCID, Structured Clinical Interview for DSM Disorders.
Centres for Disease Control and Prevention classification: Mild, <1 h or no concussion and no documented lesions; Moderate, prolonged loss of consciousness or documented intracranial or brain lesion.
OR not controlling for alcohol abuse.
OR for schizophrenia subjects vs never mentally ill subjects in combined pedigrees.
Risk for combined mild (concussion) and severe head injury calculated from data provided in article.
ORs for schizophrenia calculated from supplemental data provided by authors.
OR for TBI ≤ 15 y + narrow diagnosis.
The 3-y follow-up rate was used in analysis.
Diagnosis of psychotic disorders includes schizophrenia, hallucinations or paranoia, or organic psychotic disorder diagnosis: antipsychotic prescription. Combined risk for both mild and moderate/severe head injury calculated from data in article (3-y follow-up rates used).
OR adjusted for income and geographical location. Narrow definition ICD-9 295.