Psychiatric treatment outcome following traumatic brain injury.

The relationship between self-reported history of traumatic brain injury (TBI) and psychiatric treatment outcome was investigated. TBI was hypothesized to be frequent, associated with cognitive deficits on neuropsychological testing, and less amenable to standard psychiatric treatment. Subjects were 42 psychiatric patients with a self-reported history of TBI and 25 psychiatric patients with no TBI history. Subjects received approximately 2 weeks of inpatient psychiatric treatment. Subjects received neuropsychological testing and completed the Brief Symptom Inventory weekly. TBI was frequent (66% of subjects); multiple injuries were common. Neuropsychological performance was generally average in both groups with few group differences. Subjects, on average, reported significantly decreased psychiatric symptoms on discharge. However, the TBI group appeared to improve less than the control group; group status was a significant predictor of treatment outcome. Implications of results for assessment and treatment of psychiatric disorders in patients with a history of TBI are discussed.

The K-BIT: A screen for IQ in six diverse populations.

Performance data were collected on the Kaufman Brief Intelligence Test (K-BIT) from a total of 196 individuals from six diverse populations. College students did best, followed closely by closed head-injured adults and their controls; the order of performance then was learning-disabled children, psychiatric patients, and finally, neurosurgical patients in the acute stages of recovery.

Prevalence of traumatic brain injury in an inpatient psychiatric population.

This study investigated the prevalence of traumatic brain injury (TBI) in an inpatient psychiatric population. We hypothesized increased prevalence of TBI relative to the general population due to a variety of risk factors observed in psychiatric patients. One hundred (mean age = 34) psychiatric inpatients completed the revised Head Injury Questionnaire. Chart review of 17 subjects reporting injuries established whether injuries were documented in medical records. Sixty-eight percent of this psychiatric population reported one or more injuries in which they were unconscious or dazed. This number is higher than the prevalence in the general population. Injuries were generally of mild to moderate severity; multiple injuries were common. Chart review of 17 subjects reporting TBI indicated that histories of TBI had not been noted in the medical record. Finally, 63% of TBI subjects reported that their injury predated the onset of their psychiatric symptoms. These results suggest a possible role of TBI in psychiatric symptomatology and have implications for psychiatric treatment in this population.

Performance data for traumatic brain-injured subjects on the Gordon Diagnostic System (GDS) tests of attention.

Thirty adults with traumatic brain injury (TBI) (20 males and 10 females, mean age 40 years) and a non-injured control group (12 males and 13 females, mean age 41 years) were tested on 16 tests of attention including three tasks of the Gordon Diagnostic System (GDS), a relatively new set of attention tasks. No differences between groups were found on age or education. Both groups had estimated IQs in the average range. Performance data for the GDS are presented for the TBI and CON groups. Mild to moderate deficits of attention were seen in the TBI group relative to controls on the Vigilance and Distractibility tasks. No differences between groups were seen on the Standard Delay groups. Person product moment correlations suggested different patterns of relationships between the GDS tasks and other tests of attention for the TBI and CON groups. These results support the utility of the Vigilance and Distractibility tasks for assessment of attention in a mild to moderately injured population.