Depression is a common mental health condition that frequently occurs after traumatic brain injury (TBI) in children, adolescents and adults. Patterns of diagnosis, treatment and management for depression are influenced by sex, gender and other social determinants of health (SDoH) such as race/ethnicity and socio-economic status. Despite the known importance of these factors for both depression and TBI care, the authors report that no prior review has specifically synthesized evidence on sex- and gender-based differences, together with other SDoH, in depression-related healthcare utilisation among individuals who sustained a TBI at age ≤19 years.
The primary objective of this systematic review is to synthesize evidence on sex-based and/or gender-based findings, alongside other SDoH, in depression-related healthcare utilisation among people who sustained a TBI at or before 19 years of age. The review aims to identify how sex, gender and intersecting social factors influence the diagnosis, treatment and management of depression in this population.
Included studies must be peer-reviewed articles published in any language that meet all of the following criteria:
Studies will be excluded if they meet any of these conditions:
The review will search four electronic databases from database inception to the search date: Ovid Medline, Embase, American Psychological Association PsycINFO, and Cumulative Index of Nursing and Allied Health Literature (CINAHL). The protocol states that searches will span the full available record of each source; specific search terms and strategies were not detailed in the source text.
The review will follow established frameworks and reporting standards to ensure transparent and rigorous synthesis. Specifically, the authors will use the Joanna Briggs Institute evidence synthesis framework for knowledge synthesis. Reporting will be guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol (PRISMA-P) and PRISMA-Equity extensions, and the PROGRESS-Plus framework will be used to report equity-relevant variables and other SDoH.
The protocol focuses on extracting information related to depression-related healthcare utilisation after childhood or adolescent TBI. Outcomes of interest include measures of diagnosis, receipt of treatment, and management of depression. The review will collect sex-stratified and/or gender-stratified results, and will capture additional SDoH attributes (for example, race/ethnicity or socio-economic status) as available in included studies. The source text did not provide a detailed data extraction form or the full list of variables to be extracted.
Methodological quality of included studies will be assessed using the National Heart, Lung, and Blood Institute Quality Assessment Tool. The protocol indicates this tool will be applied to evaluate study quality, but specific thresholds for inclusion/exclusion based on quality or plans for sensitivity analyses by quality strata were not reported in the source text.
A narrative synthesis will be conducted to identify themes and attributes describing how sex, gender and other SDoH influence depression-related healthcare utilisation among individuals who sustained a TBI at ≤19 years. The protocol emphasizes thematic identification rather than specifying meta-analytic pooling; details about subgroup analyses, quantitative synthesis methods or planned meta-analyses were not reported in the source article.
No institutional ethics approval will be required because this review will not collect primary data. The authors plan to disseminate findings via a peer-reviewed publication. The protocol has been registered in PROSPERO with registration number CRD420261301669.