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Neuropsychiatric Complications of Traumatic Brain Injury

A Critical Review of the Literature (A Report by the ANPA Committee on Research)

Received May 15, 2006; accepted May 19, 2006. Dr. Kim is affiliated with Bristol-Myers Squibb, Neuroscience Medical Strategy, Plainsboro, New Jersey. Drs. Lauterbach and Coburn are affiliated with the Departments of Psychiatry and Behavioral Science, Mercer University School of Medicine, Macon, Georgia. Dr. Reeve is affiliated with the Department of Psychiatry, New Mexico School of Medicine, Albuquerque, New Mexico. Dr. Arciniegas is affiliated with the Department of Psychiatry, University of Colorado School of Medicine, Denver, Colorado. Dr. Mendez is affiliated with the Department of Psychiatry, University of California, Los Angeles, School of Medicine, Los Angeles, California. Dr. Rummans is affiliated with the Department of Psychiatry, Mayo Clinic College of Medicine, Rochester, Minnesota. Dr. Coffey is affiliated with the Department of Psychiatry and Neurology, Henry Ford Health System, Detroit, Michigan. Address correspondence to Dr. Kim, Bristol-Myers Squibb Company, 777 Scudders Mill Road, Plainsboro, NJ 08536; edward.kim{at}bms.com (e-mail).

Psychiatric disorders frequently complicate recovery and rehabilitation from traumatic brain injury (TBI). This study reviews the literature from 1978 to 2006 on psychosis, depression, posttraumatic stress disorder, mania, and aggression following nonpenetrating TBI. The studies were reviewed using the American Academy of Neurology’s criteria for classification of articles on diagnostic methods. No studies were found to be Class I or II. Of the 66 studies reviewed, the majority were Class IV. There are significant gaps in the literature on post-TBI psychiatric conditions with respect to nosology, epidemiology, and risk factors. Larger multicenter prospective studies using standardized diagnostic instruments are needed to further clarify the nosology, risk factors, and clinical course of these disorders. Specific directions for research are provided.

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