Attention-deficit hyperactivity symptomatology after traumatic brain injury: a prospective study.
OBJECTIVE
To study prospectively the course of attention-deficit hyperactivity (ADH) symptomatology in children and adolescents after traumatic brain injury (TBI). It was hypothesized that ADH symptomatology would be significantly related to severity of injury.


METHODS
Subjects were children (n = 50) aged 6 to 14 years at the time they were hospitalized after TBI. The study used a prospective follow-up design. Assessments of preinjury psychiatric, behavioral, socioeconomic, family functioning, and family psychiatric history status were conducted. Severity of injury was assessed by standard clinical scales, and neuroimaging was analyzed.


RESULTS
The main finding of this study was that change in ADH symptomatology in the first 2 years after TBI in children and adolescents was significantly related to severity of injury. Overall ADH symptomatology during the study was significantly related to a measure of family dysfunction when family psychiatric history, socioeconomic status, and severity of injury were controlled.


CONCLUSIONS
The presence of a positive "dose-response" relationship between severity of injury and change in ADH symptoms, present from the 3-month assessment, was consistent with an effect directly related to brain damage.
Department of Psychiatry, University of Iowa, Iowa City 52242, USA.
J E
JE
Max
S
S
Arndt
C S
CS
Castillo
H
H
Bokura
D A
DA
Robin
S D
SD
Lindgren
W L
WL
Smith
Y
Y
Sato
P J
PJ
Mattheis
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology*; D001930:Brain Injuries / Q000150:complications*; D002648:Child; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D013997:Time Factors