title: Psychiatric disorders in children and adolescents in the first six months after mild traumatic brain injury.
abstract: The objective was to assess the nature, rate, predictive factors, and neurocognitive correlates of novel psychiatric disorders (NPD) after mild traumatic brain injury (MTBI). Children age 5-14 years with MTBI (N=87) from consecutive admissions to five trauma centers were enrolled and studied with semistructured psychiatric interviews soon after injury (baseline), and 70 of these children were assessed again 6 months post-injury. Injury severity; lesion characteristics; pre-injury variables, including psychiatric disorder, family psychiatric history, family functioning, socioeconomic status, psychosocial adversity, and adaptive functioning; and post-injury neurocognitive and adaptive functioning measures were assessed with standardized instruments. NPD occurred in 25 of 70 participants (36%) in the first 6 months after injury. NPD at 6 months was predicted by the presence of frontal white-matter lesions on MRI at 3 months post-injury, and was associated with concurrent decrements on neurocognitive indices of processing speed, expressive language, and intellectual functioning. NPD was not predicted by other indices of severity, pre-injury psychosocial variables, estimated pre-injury academic functioning, or adaptive and executive function decrements 6 months post-injury. These findings suggest that short-term psychiatric morbidity associated with MTBI in children and adolescents may be more common than previously thought and may have readily identifiable neuroimaging and neurocognitive correlates.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Max
authors.forename: Russell J
authors.initials: RJ
authors.lastname: Schachar
authors.forename: Julie
authors.initials: J
authors.lastname: Landis
authors.forename: Erin D
authors.initials: ED
authors.lastname: Bigler
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Wilde
authors.forename: Ann E
authors.initials: AE
authors.lastname: Saunders
authors.forename: Linda
authors.initials: L
authors.lastname: Ewing-Cobbs
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Chapman
authors.forename: Maureen
authors.initials: M
authors.lastname: Dennis
authors.forename: Gerri
authors.initials: G
authors.lastname: Hanten
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology; D001930:Brain Injuries / Q000150:complications*; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D013223:Statistics as Topic