Psychiatric disorders in children and adolescents after severe traumatic brain injury: a controlled study.
OBJECTIVE
To study psychiatric and behavioral morbidity associated with severe traumatic brain injury (TBI).


METHODS
A consecutive series (n = 24) of children aged 5 through 14 years who suffered a severe TBI were matched to subjects who sustained a mild TBI and to a second matched group who sustained an orthopedic injury with no evidence of TBI. Standardized psychiatric, behavioral, and neuroimaging assessments were conducted on average 2 years after injury.


RESULTS
Severe TBI was associated with a significantly higher rate of current "novel" psychiatric disorders (15/24; 63%) compared with children with mild TBI (5/24; 21%) and orthopedic injury (1/24; 4%). Higher effect sizes were evident for child and adolesent self-report of internalizing symptoms rather than externalizing symptoms, for parents' report of overall behavior and internalizing symptoms rather than externalizing symptoms, and for teachers' reports of overall behavior and externalizing symptoms rather than internalizing symptoms.


CONCLUSIONS
Severe TBI is a profound risk factor for the development of a psychiatric disorder. Survivors should be assessed for organic personality syndrome, which is the most common psychiatric disorder after this type of injury.
Max
J E
JE
Department of Psychiatry, University of Iowa, Iowa City 52242, USA.
Koele
S L
SL
Smith
W L
WL
Sato
Y
Y
Lindgren
S D
SD
Robin
D A
DA
Arndt
S
S
D000293:Adolescent; D000704:Analysis of Variance; D001930:Brain Injuries / Q000150:complications / Q000523:psychology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D016017:Odds Ratio; D017741:Survivors / Q000523:psychology*