ABSTRACT
A record review focused on children and adolescents, with a history of traumatic brain injury (TBI), who were consecutively admitted to a brain injury clinic in which all new patients are psychiatrically evaluated. Correlates of post-injury oppositional defiant disorder/conduct disorder (ODD/CD) and post-injury attention deficit hyperactivity disorder (AHD) were investigated. Subjects who developed ODD/CD following TBI, when compared to subjects without a lifetime history of the disorder, had significantly more impaired family functioning, showed a trend toward a greater family history of alcohol dependence/abuse and suffered a milder TBI. In contrast, there were no variables which discriminated between subjects who developed ADHD following injury and those with no lifetime history of ADHD. It is difficult to determine whether ODD, CD and ADHD occurring after TBI in the patient is related to the TBI, directly or indirectly. Appropriate clinical assessment requires consideration of the important mediating role of family functioning, severity of injury and family psychiatric history.
Subject(s)
Brain Injuries/complications , Child Behavior Disorders/etiology , Adolescent , Alcoholism/genetics , Analysis of Variance , Attention Deficit Disorder with Hyperactivity/etiology , Child , Communication Disorders/etiology , Educational Measurement , Family Health , Family Relations , Female , Humans , Injury Severity Score , Intelligence , Interview, Psychological , Male , Mental Disorders/genetics , Personality Disorders/etiology , Retrospective StudiesABSTRACT
A record review focused on children and adolescents, with a history of traumatic brain injury, who were consecutively admitted to a brain injury clinic in which all new patients are psychiatrically evaluated. Significant correlates of severity of injury in the cognitive, education and communication domains of functioning included Performance IQ but not Verbal IQ nor standardized ratings of language or learning disability. Current organic personality syndrome (OPS) but not attention deficit hyperactivity disorder or oppositional defiant disorder/conduct disorder diagnostic status was significantly related to severity. In conclusion, the findings in this referred sample are similar to prospective studies indicating that Performance IQ appears sensitive in reflecting brain damage. The finding linking OPS to severity of injury is not surprising. This is because OPS is a diagnosis which is dependent on the clinician's judgment of the likelihood that the organic factor is etiologically related to a defined behavioural syndrome. The diagnosis therefore requires a clinical judgment that the threshold of severity of a presumed organic etiological factor has been reached.
Subject(s)
Brain Injuries/complications , Developmental Disabilities/etiology , Injury Severity Score , Personality Disorders/etiology , Adolescent , Analysis of Variance , Attention Deficit Disorder with Hyperactivity/etiology , Brain Damage, Chronic/etiology , Child , Child Behavior Disorders/etiology , Cognition Disorders/etiology , Communication Disorders/etiology , Educational Measurement , Female , Humans , Intelligence , Interview, Psychological , Language Disorders/etiology , Learning Disabilities/etiology , Male , Neuropsychological Tests , Prospective Studies , Retrospective Studies , Verbal BehaviorABSTRACT
A record review focused on children and adolescents, with a history of traumatic brain injury, who were consecutively admitted to a brain injury clinic in which all new patients are psychiatrically evaluated. The development of a 'novel' psychiatric disorder (not present before injury) occurred in 76% (38/50) of the cohort and was correlated significantly with family psychiatric history and family function, but not with severity of injury, preinjury psychiatric status, intellectual/educational functioning, or socioeconomic status. Psychiatric consultation is often necessary in this paediatric population even though much of the psychopathology, particularly following mild injury, may not be directly related to brain trauma.
