Psychiatric disorders in children and adolescents in the first six months after mild traumatic brain injury

J Neuropsychiatry Clin Neurosci. 2013 Summer;25(3):187-97. doi: 10.1176/appi.neuropsych.12010011.

Abstract

The objective was to assess the nature, rate, predictive factors, and neurocognitive correlates of novel psychiatric disorders (NPD) after mild traumatic brain injury (MTBI). Children age 5-14 years with MTBI (N=87) from consecutive admissions to five trauma centers were enrolled and studied with semistructured psychiatric interviews soon after injury (baseline), and 70 of these children were assessed again 6 months post-injury. Injury severity; lesion characteristics; pre-injury variables, including psychiatric disorder, family psychiatric history, family functioning, socioeconomic status, psychosocial adversity, and adaptive functioning; and post-injury neurocognitive and adaptive functioning measures were assessed with standardized instruments. NPD occurred in 25 of 70 participants (36%) in the first 6 months after injury. NPD at 6 months was predicted by the presence of frontal white-matter lesions on MRI at 3 months post-injury, and was associated with concurrent decrements on neurocognitive indices of processing speed, expressive language, and intellectual functioning. NPD was not predicted by other indices of severity, pre-injury psychosocial variables, estimated pre-injury academic functioning, or adaptive and executive function decrements 6 months post-injury. These findings suggest that short-term psychiatric morbidity associated with MTBI in children and adolescents may be more common than previously thought and may have readily identifiable neuroimaging and neurocognitive correlates.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Brain / pathology
  • Brain Injuries / complications*
  • Child
  • Cohort Studies
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / etiology*
  • Mental Disorders / psychology
  • Neurologic Examination
  • Neuropsychological Tests
  • Psychiatric Status Rating Scales
  • Psychological Tests
  • Statistics as Topic