Axis I and II psychiatric disorders in patients with traumatic brain injury: a 12-month follow-up study.

OBJECTIVE

To evaluate the occurrence of axis I and II psychiatric disorders among patients with traumatic brain injury (TBI).

DESIGN

Prospective observational study. Forty-five adult patients, who had attended an emergency unit because of TBI, were recruited. At 12 months, 38 patients were interviewed.

MEASURES

Psychiatric disorders were evaluated using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II).

RESULTS

Before TBI, the 12-month rate of axis I psychiatric disorders was relatively high (39.5%) and the rate of alcohol dependence was especially elevated (18.4%). During the 12 months after TBI, axis I disorders were found in 47.4% of subjects. Six patients (15.8%) were found to have a disorder with an onset after TBI. Of these, five patients had depressive disorders (13.2%). Almost one third of the subjects (29.0%) had personality disorders. Antisocial and obsessive-compulsive personality disorders were the most frequent (10.5%).

CONCLUSIONS

Both axis I and II psychiatric disorders are common among patients with TBI. Alcohol dependence and personality disorders are prevalent in individuals prone to TBI, whereas depressive disorders typically develop after injury. Psychiatric disorders should be addressed in rehabilitation, as otherwise they will hinder the recovery after TBI.