Novel Psychiatric Disorder 6 Months After Traumatic Brain Injury in Children and Adolescents

Authors

Jeffrey E Max
Imogen Drake
Florin Vaida
John R Hesselink
Linda Ewing-Cobbs
Russell J Schachar
Sandra B Chapman
Erin D Bigler
Elisabeth A Wilde
Ann E Saunders
Tony T Yang
Olga Tymofiyeva
Harvey S Levin

Publication Date

1-1-2023

Journal

The Journal of Neuropsychiatry

Abstract

OBJECTIVE: To investigate the factors predictive of novel psychiatric disorders in the interval 0-6 months following traumatic brain injury (TBI).

METHODS: Children ages 5-14 years consecutively hospitalized for mild to severe TBI at five hospitals were recruited. Participants were evaluated at baseline (soon after injury) for pre-injury characteristics including psychiatric disorders, socioeconomic status (SES), psychosocial adversity, family function, family psychiatric history, and adaptive function. In addition to the psychosocial variables, injury severity and lesion location detected with acquisition of a research MRI were measured to develop a biopsychosocial predictive model for development of novel psychiatric disorders. Psychiatric outcome, including occurrence of a novel psychiatric disorder, was assessed 6 months after the injury.

RESULTS: The recruited sample numbered 177 children, and 141 children (80%) returned for the six-month assessment. Of the 141 children, 58 (41%) developed a novel psychiatric disorder. In univariable analyses, novel psychiatric disorder was significantly associated with lower SES, higher psychosocial adversity, and lesions in frontal lobe locations, such as frontal white matter, superior frontal gyrus, inferior frontal gyrus, and orbital gyrus. Multivariable analyses found that novel psychiatric disorder was independently and significantly associated with frontal-lobe white matter, superior frontal gyrus, and orbital gyrus lesions.

CONCLUSION: The results demonstrate that occurrence of novel psychiatric disorders following pediatric TBI requiring hospitalization is common and has identifiable psychosocial and specific biological predictors. However, only the lesion predictors were independently related to this adverse psychiatric outcome.

Keywords

Pediatric traumatic brain injury, Novel Psychiatric Disorder, prospective longitudinal study

Comments

PMID: 35989573