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Asia has the highest percentage of Traumatic Brain Injury (TBI)-related outcomes, among other regions in the world. Lower-middle income countries (LMICs) report thrice the total TBIs compared with Higher-income countries (HICs). Despite the high prevalence of patients with TBI in the region, TBI-related psychiatric disorders are often given the least priority in trauma management.
This study focuses on LMICs in the Asia-Pacific region and examines existing literature within the past decade to (1) identify the common psychiatric conditions associated with TBI; (2) determine the most commonly used pharmacologic and nonpharmacologic psychiatric interventions in the management of TBI-related psychiatric disorders; and (3) identify the barriers in the screening, diagnosis, and management of these TBI-related psychiatric conditions.
The researchers used a scoping review methodology to search relevant articles through nine online databases (e.g., PubMed, Google Scholar, Cochrane). Findings were reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Upon review, 75 journals were included in the current study. Among the articles, there are limited studies among Asia-Pacific LMICs that focus on this topic.
Post-traumatic stress disorder, major depressive disorder, and substance-related disorders were among the common psychiatric sequelae of TBI reported in 54 studies. Forty-two articles highlighted the effectiveness of antidepressants and Cognitive Behavioral Therapy (CBT) in managing TBI-related psychiatric disorders. Barriers to managing these conditions in Asia-Pacific LMICs include low socioeconomic status, psychiatric illness stigma, and the scarcity of healthcare resources.
The psychiatric care in the management of TBI patients is clearly recognized but often overlooked. As LMICs struggle to provide a holistic approach to TBI cases in the face of limited resources, there emerges the need to raise awareness and encourage resourcefulness in utilizing accessible management and treatment strategies that can be used in different trauma centers in the region.
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