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Psychosis is a rare but devastating sequela of traumatic brain injury (TBI). This study examined risk factors for developing a psychosis secondary to TBI (PSTBI). Demographics of 25 inpatients with PSTBI were statistically analyzed for risk factors. Data from the PSTBI group were also compared with data from a control group of TBI patients without psychosis. Results indicate the PSTBI group was more likely to have had a previous congenital neurological disorder or to have sustained a head injury prior to adolescence. The PSTBI also had a higher proportion of males. Discussion focuses on potential models for developing PSTBI.