J Neuropsychiatry Clin Neurosci 12:316-327, August 2000
© 2000 American Psychiatric Press, Inc.
Can Traumatic Brain Injury Cause Psychiatric Disorders?
Robert van Reekum, M.D., F.R.C.P.C.,
Tammy Cohen, B.A.(H) and
Jenny Wong, B.A.(H)
Received May 25, 1999; revised November 19, 1999; accepted December 21, 1999. From the Department of Psychiatry and Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care; Division of Geriatric Psychiatry, University of Toronto; and Department of Psychiatry, Baycrest Centre for Geriatric Care. Address correspondence to Dr. van Reekum, Baycrest Centre for Geriatric Care, 3560 Bathurst St. North York, Ontario, M6A 2E1.
Traumatic brain injury (TBI) may cause psychiatric illness. This article reviews the evidence on the basis of an established set of causation criteria. The evidence is convincing for a strong association between TBI and mood and anxiety disorders. Substance abuse and schizophrenia are not strongly associated with TBI, and there is little research into the rates of personality disorders after TBI. Evidence for a biologic gradient is lacking, but such a gradient may not be relevant to TBI. Evidence for the correct temporal sequence is present. Preliminary evidence suggests a biologic rationale for TBI causing psychiatric illness. Further and methodologically improved research is supported and required.
Key Words: Traumatic Brain Injury
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