Psychiatric disorders in children and adolescents 24 months after mild traumatic brain injury.
This study aimed to better understand the occurrence of novel psychiatric disorders (NPDs) in children with mild traumatic brain injury (mTBI) in relation to preinjury variables, injury-related variables, and concurrent neurocognitive outcome. Eighty-seven children aged 5-14 years who had experienced mTBI were studied from consecutive hospital admissions with semistructured psychiatric interviews soon after injury (baseline). Fifty-four children were reassessed 24 months postinjury. Standardized instruments were used to evaluate injury severity, lesion characteristics, preinjury variables (lifetime psychiatric disorder, family psychiatric history, family function, socioeconomic status, psychosocial adversity, adaptive function, and academic function), and finally, postinjury neurocognitive and adaptive function. At 24 months postinjury, NPDs had occurred in 17 of 54 (31%) participants. NPD at 24 months was related to frontal white matter lesions and was associated with estimated preinjury reading, preinjury adaptive function, and concurrent deficits in reading, processing speed, and adaptive function. These findings extend earlier reports that the psychiatric morbidity after mTBI in children is more common than previously thought, and moreover, it is linked to preinjury individual variables and injury characteristics and is associated with postinjury adaptive and neurocognitive functioning.
From the Dept. of Psychiatry, UC San Diego, San Diego, CA, and Rady Children's Hospital, San Diego, CA (JEM); Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (KF); Baylor College of Medicine, Houston, TX (EAW); Brigham Young University, Provo, UT (EDB); University of Toronto, Toronto, Canada (RJS); University of Texas Health Science Center, Houston, TX (AS); University of Toronto, Toronto, Canada (MD [deceased]; University of Texas Health Science Center, Houston, TX (LE-C); University of Texas, Dallas, TX (SBC); University of California, San Francisco, CA (TTY); Baylor College of Medicine, Houston, TX (HSL).
Jeffrey E
JE
Max
Keren
K
Friedman
Elisabeth A
EA
Wilde
Erin D
ED
Bigler
Gerri
G
Hanten
Russell J
RJ
Schachar
Ann E
AE
Saunders
Maureen
M
Dennis
Linda
L
Ewing-Cobbs
Sandra B
SB
Chapman
Tony T
TT
Yang
Harvey S
HS
Levin
D000293:Adolescent; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology*; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales