Frequency of brain injury in a forensic psychiatric population

Abstract

OBJECTIVE: Over the last years, a growing number of studies involving individual patients and/or populations have demonstrated that Traumatic Brain Injuries (TBI) determine innumerable psychiatric symptoms, including significant alterations which may influence diagnoses, prognosis and treatment, not to mention clear psychosocial implications (both legal and those related to social security). The objectives of this study were 1) to detect the existence of TBI in a forensic psychiatric population before the occurrence of the wrongs; 2) To verify whether or not those injuries had been identified by the experts at the psychiatric institution. METHOD: 3,323 records of patients examined by forensic experts at the Forensic Psychiatric Institute Dr. Maurício Cardoso in Porto Alegre were analyzed; the records covered the period between 1995 and 1999. RESULTS: in the studied population, there were 133 cases of TBI prior to the wrongs, 39 of which were mild, and 94, moderate or severe. Out of the total number of TBI cases found, 111 cases were not taken into account, many of them having motoric, cognitive, psychic and sensori perception alterations. CONCLUSION: the significant number of patients that had had TBI before having committed a wrong - a fact that had not been considered by the experts (neurologists and psychiatrists) at the institution - is a strong indicator of how little attention is paid to the consequences of these injuries. Considering the relevance of the psychosocial aspects, new studies should be conducted in psychiatric populations to increase the knowledge about the consequences of these injuries.

Traumatic brain injury in a prison population: Prevalence and risk for re-offending

“…There were concomitant reports of difficulties with memory and socialization. De Souza [18] examined the existence of TBI in a forensic psychiatric population in Brazil through analysis of medical records. Of 3233 offenders there were 133 cases of TBI reported (39 'mild' and 94 'moderate or severe').…”

The prevalence of traumatic brain injury (TBI) among people impacted by the criminal legal system: An updated meta-analysis and subgroup analyses.

“…However, results from the Egger’s test were nonsignificant ( p = .16), indicating that the relationship between sample size and prevalence is not statistically significant. Results of the leave-one-out sensitivity analyses indicated that no individual studies disproportionately affected the pooled estimate, with the exception of de Souza (2003). When that study was excluded, the prevalence estimate was reduced to 28.5%…”

Acquired Brain Injury and Interventions in the Offender Population: A Systematic Review

“…In comparison with the general population, prevalence of ABI in the offender population is considerably higher (21), and those estimations are likely to be underestimations because research in offender populations typically only focuses on TBI, and information about non-traumatic brain injury is usually not available. With regard to a specific subgroup of the offender population, namely forensic psychiatric patients who undergo treatment, comparable high prevalence rates have been reported (21,22). The prevalence and extent of brain pathology in institutionalized offenders, compared to non-offenders, was significantly higher with a prevalence of 46% vs. 8% (21).…”