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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0781

Depression in military personnel and veterans with blast-related traumatic brain injury: a systematic review of prevalence, comparative risk, and neurobiology

DEPRESSION AMONG MILITARY PERSONNEL AND VETERANS WITH BLAST- RELATED TRAUMATIC BRAIN INJURY: A SYSTEMATIC REVIEW OF PREVALENCE, COMPARATIVE RISK, AND NEUROBIOLOGY

The prevalence and symptom severity of major depressive disorder in military personnel and veterans with blast-related traumatic brain injury are substantially higher than in military controls without traumatic brain injury and are associated with widespread alterations in frontolimbic networks.

The aim was to determine the pooled prevalence, symptom severity, and neurobiological correlates of major depressive disorder (MDD) in military personnel and veterans (MP-V) with blast-related traumatic brain injury (B-TBI). The review was conducted in accordance with the PRISMA 2020 guidelines, with a literature search across five databases. Screening, data extraction, and quality assessment were performed by two independent researchers using Joanna Briggs Institute (JBI) checklists, and qualitative and meta-analytic synthesis, subgroup analysis, and meta-regression were conducted. Across the cohorts included in the meta-analysis, veteran samples contributed more than twice as many study arms as active-duty samples, MDD ascertainment was based predominantly on clinical diagnosis rather than symptom screening, mean ages ranged from 30 to 35 years, and sample sizes were generally small. Across nineteen studies, the pooled prevalence of MDD in exposed personnel was 41.7% (95% confidence interval 35.7–47.9); estimates were nearly identical for blast-related TBI (41.2%) and mixed-mechanism TBI (41.3%), whereas prevalence in MP-V without TBI was 24.6% (95% CI 15.0–37.6), with substantial heterogeneity (I2=97%). Across thirteen studies, groups with TBI or blast exposure showed significantly greater depressive symptom severity than controls without TBI (Hedges' g=0.93; 95% CI 0.66–1.19; Z=6.86; P<0.001), representing a large effect size; comparisons between B-TBI and TBI were fewer and showed no significant difference (g=0.42; 95% CI −0.31 to 1.16). White matter integrity was the principal domain of neurobiological findings, with 13 studies reporting lower fractional anisotropy in the anterior corona radiata and superior longitudinal fasciculus in depressed groups; studies of metabolism/perfusion, functional connectivity, and structural imaging each contributed 7 reports, with recurring findings of regional hypometabolism, altered frontal network connectivity, and fronto-insular cortical thinning. Peripheral markers included elevated exosomal tau, amyloid-beta 42, inflammatory burden, and testosterone abnormalities or pituitary axis dysfunction. In conclusion, MDD prevalence and severity tend to be higher in MP-V with B-TBI, underscoring the need for screening to facilitate early diagnosis and for integrating mental health treatment into TBI rehabilitation programs.

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