Axis I and II Psychiatric Disorders After Traumatic Brain Injury: A 30-Year Follow-Up Study

Koponen, Seppo; Taiminen, Tero; Portin, Raija; Himanen, Leena; Isoniemi, Heli; Heinonen, Hanna; Hinkka, Susanna; Tenovuo, Olli

doi:10.1176/appi.ajp.159.8.1315

Cited by 434 publications

(257 citation statements)

References 31 publications

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“…In addition to the changes in cognition, behavior, and personality described above, a significant body of evidence suggests that TBI results in an increased relative risk of developing various psychiatric disorders, including mood and anxiety disorders, substance abuse and psychotic syndromes (73)(74)(75)(76). For example, Kopenen et al (76) studied 60 individuals 30 years after their TBI and found that almost half (48%) developed a new Axis I psychiatric disorder after their injury.…”

Section: Relationship Of Tbi To Psychiatric Disordersmentioning

confidence: 99%

Neurobehavioral sequelae of traumatic brain injury: evaluation and management

2008

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Traumatic brain injury (TBI) is a universal public health problem. A recent review of epidemiological studies in Europe suggests an incidence of 235 hospitalized cases (including fatalities) per 100,000 population (1). In the US, the incidence is estimated at 150 per 100,000 population (2). Less data is available from other regions of the world, but TBI is acknowledged as a significant problem worldwide. Of note is that the incidence rates are calculated from hospitalized cases only, and do not include injured individuals who do not seek or have access to care. Thus, the actual incidence of injury is probably 3 to 4 fold larger than the quoted numbers. Most studies suggest that the incidence rates for TBI are greatest in the second and third decades of life, with a secondary increase in the elderly stemming from falls (2,3). Males are more likely to suffer a TBI than females (2,3).In developed countries, there has been a reduction in the mortality rates associated with TBI over the last several decades, generally attributed to improved systems of trauma care and improved motor vehicle safety design. Many individuals with mild traumatic brain injury and virtually all individuals who survive moderate and severe TBI are left with significant long-term neurobehavioral sequelae (4-6). Thus, the reduction in TBI-associated mortality rates (7) has led to a significant increase in the number of individuals with long-term neurobehavioral disorders related to TBI (8,9).Brain trauma can be caused in a number of ways, including mechanisms which penetrate the substance of the brain (e.g., projectiles) and those that do not. This paper focuses on non-penetrating injuries. Despite different contexts and instruments, the physics and biomechanics underlying damage to the brain from non-penetrating injuries have some common features. This results in certain brain regions being at greater risk for damage than others and allows for some general statements to be made about typical profiles of brain injury associated with trauma. The assessment and treatment of the neurobehavioral sequelae of TBI follow logically from an understanding of this injury profile. RELATIONSHIP OF PROFILE OF INJURY TO NEUROBEHAVIORAL SEQUELAEThere are two broad categories of forces that result in brain injury: contact (or impact) and inertial (acceleration or deceleration). Contact injuries result from the brain coming into contact with an object (which might include the skull, or some external object). Contact mechanisms often result in damage to scalp, skull, and brain surface (e.g., contusions, lacerations, hematomas) (10). Frequent sites of such injury are the anterior temporal poles, lateral and inferior temporal cortices, frontal poles, and orbital frontal cortices.Inertial injury results from rapid acceleration or deceleration of the brain that produces shear, tensile, and compression forces. These forces have maximum impact on axons and blood vessels, resulting in axonal injury, tissue tears, and intracerebral hematomas. These mechanisms also produc...

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Section: Relationship Of Tbi To Psychiatric Disordersmentioning

confidence: 99%

Neurobehavioral sequelae of traumatic brain injury: evaluation and management

2008

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“…Anxiety disorders are common comorbidities associated with traumatic brain injury (TBI) [1][2][3]. As defined by the Centers for Disease Control and Prevention, anxiety disorders have an aggregate 12 month prevalence of 10% among the general population [4].…”

Section: Introductionmentioning

confidence: 99%

Anxiety following traumatic brain injury: Impact on post-hospital rehabilitation outcomes

Horn¹,

Lewis²,

Russell³

et al. 2017

Phys Med Rehabil Res

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“…Specifically, about 1.1% of the US population is living with long-term disability as a result of TBI [1], which often includes psychiatric disorders, most commonly depression [2]. Although the risk for developing Major Depressive Disorder (MDD) is significant in the first year after TBI [3], an elevated risk for depression persists across the lifespan.…”

Section: Introductionmentioning

confidence: 99%