Characteristics of Psychotic Disorder Due to Traumatic Brain Injury: An Analysis of Case Studies in the Literature

Abstract

The authors analyzed data from 69 published case studies of Psychotic Disorder Due to Traumatic Brain Injury (PDTBI) in order to describe its common characteristics and assist in its diagnosis and differentiation from schizophrenia. The majority of these PDTBI patients were males with onset of symptoms occurring within the first 2 years after moderate to severe head injury. A majority showed abnormalities on MRI/CT and EEG with localization in the frontal and temporal areas. The general presentation included delusions and hallucinations without co-occurring negative symptoms. The findings demonstrate that patients with PDTBI have a profile that distinguishes itself from schizophrenia.

A Patient With Psychotic Disorder Following Traumatic Brain Injury With Bilateral Frontal Lobe Damage

“…The cranial MRI of our patient showed bilateral frontal severe encephalomacia. It has also been reported that rate of neuroimaging abnormalities was considerably high (65%) in post-traumatic psychosis [2] and frontal-temporal lobes were the most common areas affected in this patient group [1]. Another clue for the diagnosis of post-traumatic psychosis is accompanying cognitive impairment [2] which was prominent in executive functions in our patient.…”

“…It has also been reported that rate of neuroimaging abnormalities was considerably high (65%) in post-traumatic psychosis [2] and frontal-temporal lobes were the most common areas affected in this patient group [1]. Another clue for the diagnosis of post-traumatic psychosis is accompanying cognitive impairment [2] which was prominent in executive functions in our patient. Nonetheless, the presence of other clinical signs of disturbed executive functions and emotional and motivational alterations might rather be attributed to frontal-subcortical system dysfunction and related syndromes (dorsolateral syndrome, orbitofrontal syndrome, and anterior cingulate syndrome), other than solely the process of psychosis.…”

Long-Term Neuropsychiatric Disorders After Traumatic Brain Injury

“…Van Reekum and colleagues (2000) reviewed data from more recent studies and found a prevalence of post-traumatic schizophrenia of 0.7%. Men appear to be more frequently affected by post-head injury psychosis than women (Fujii et al 2002). David and Prince (2005) appraised the literature to identify a causal role of TBI in schizophrenia and concluded that the evidence for such an association does not exist.…”

“…Prodromal symptoms are common and they include depression, antisocial and inappropriate social behaviour, social withdrawal and deterioration at work. Negative and catatonic features are unusual (Sachdev et al 2001;Fujii & Ahmed, 2002). Sachdev and colleagues (2001) reported a mean latency of 54.7 months between head injury and onset of psychosis, with the minimum being two weeks and the maximum 17 years.…”

“…Some studies suggest that psychosis is related to left sided and temporal injuries but others find no relationship to the type or location of the injury. Fujii and Ahmed (2002) analysed data from 69 published case studies of psychotic disorder due to TBI in order to describe common characteristics. They found abnormalities on EEGs in 70% of cases, especially within the temporal lobes and almost 30% had seizures.…”