The association between head injuries and psychiatric disorders: findings from the New Haven NIMH Epidemiologic Catchment Area Study.
OBJECTIVE
To determine the association of report of any history of head injury with loss of consciousness or confusion and a lifetime diagnosis of psychiatric disorder in a general population.


METHODS
A probability sample of adults from the New Haven portion of the NIMH Epidemiologic Catchment Area programme were administered standardized and validated structured interviews. The main outcome measures were lifetime prevalence of psychiatric disorders and suicide attempt in individuals with and without a history of traumatic brain injury.


RESULTS
Among 5034 individuals interviewed, 361 admitted to a history of severe brain trauma with loss of consciousness or confusion (weighted rate of 8.5/100). When controlling for sociodemographic factors, quality of life indicators and alcohol use, risk was increased for major depression, dysthymia, panic disorder, OCD, phobic disorder and drug abuse/dependence. In addition, lifetime risk of suicide attempt was greater in those who had suffered head injury.


CONCLUSIONS
Individuals with a history of traumatic brain injury have significantly higher occurrence for psychiatric disorders and suicide attempts in comparison with those without head injury and have a poorer quality of life. Future studies should examine the nature of this relationship, focusing on the severity of the brain injury and the temporal contiguity of the brain injury and psychiatric disorder.
Silver
J M
JM
New York University School of Medicine, NY, USA. jonsilver@aol.com
Kramer
R
R
Greenwald
S
S
Weissman
M
M
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001930:Brain Injuries / Q000453:epidemiology* / Q000523:psychology*; D002391:Catchment Area, Health; D015897:Comorbidity; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D009315:National Institute of Mental Health (U.S.); D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D011788:Quality of Life; D012494:Sampling Studies; D017678:Sex Distribution; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D014481:United States