Psychiatric comorbidities in people with and without post-traumatic epilepsy: a systematic review and meta-analysis.

INTRODUCTION: While both traumatic brain injury (TBI) and epilepsy are independently associated with psychiatric comorbidities, population-based evidence on the association between post-traumatic epilepsy (PTE) and psychiatric comorbidities is limited. We systematically reviewed psychiatric comorbidities in people with vs. without PTE. METHODS: We followed PRISMA reporting standards. Records were searched until August 2026 from MEDLINE, Embase, and PsycINFO, and were included if reported psychiatric comorbidities among people with PTE compared to control groups of i) epilepsy, ii) TBI-no-epilepsy, and/or iii) no-TBI-no-epilepsy. RESULTS: Of 1275 records identified, 6 were included. Sufficient data for meta-analysis was available only for depression. A pooled analysis of 2 studies on 81 people with PTE and 515 people with TBI-no-epilepsy showed no significantly different incidence proportion of depression between PTE and TBI-no-epilepsy (24/81[29.6%] vs. 121/515[23.4%]; RR:1.20 95%CI:0.83-1.74). CONCLUSION: Previous evidence is sparse. We observed no significant difference in depression incidence in PTE vs. TBI-no-epilepsy. Future research should explore psychiatric comorbidities in PTE vs. TBI-no-epilepsy, epilepsy-only, and healthy controls.