Somatic Symptom and Related Disorders and Mild Traumatic Brain Injury: A Systematic Review

A comprehensive systematic review of the relationship between somatic symptoms and related disorders (SSRD) and mild traumatic brain injury (mTBI).

Searches for SSRD, mTBI and related terms were performed and combined from the following databases on March 7, 2024: Ovid MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, SPORTDiscus, PsycINFO, Embase, and Scopus. Studies were included if they met the following criteria: (1) recruitment of human participants, (2) diagnosis of SSRD or validated measure of somatization, (3) reported on patients meeting diagnostic criteria for mTBI, (4) evaluated an association between mTBI and SSRD as a main outcome, (5) published in a peer-reviewed journal, and (6) published before March 7, 2024. Each of these studies were assessed for risk of bias using the Scottish Intercollegiate Guidelines Network (SIGN) criteria checklist.

Out of 6009 unique titles and abstracts, 192 full manuscripts were screened, and 43 studies were included. Of these, 9 studies reported associations between functional seizures and history of mTBI. Thirty-one studies assessed relationships between questionnaires assessing SSRD burden (eg, Patient Health Questionnaire-15) and mTBI. Three studies investigated health care practitioner diagnosis of SSRD and post-mTBI symptom burden. Thirty-six studies of the 43 studies reviewed had a risk of bias rating of unacceptable, 4 were considered high quality and another 3 were considered acceptable risk of bias.

The majority of the acceptable evidence supported a relationship between SSRD and mTBI. However, there were few acceptable or high-quality studies available and further research on this topic is needed.