TRAUMATIC BRAIN INJURY IN A CHILD-PSYCHIATRY OUTPATIENT-CLINIC - A CONTROLLED-STUDY

Objective: To demonstrate the similarity of children with a history of traumatic brain injury (TBI), particularly mild TBI, to matched child ren without such a history, within a child psychiatry outpatient clini c. Method: This is a chart review of patients presenting to a child ps ychiatry outpatient clinic over a 3-year period. Children with TBI wer e matched by age, sex, race, and social class to children with no hist ory of TBI. Axis I and II diagnoses, use of special education services , and IQ scores were compared. Results: Seventy-four (5.6%) of 1,333 c onsecutive clinic cases had a definite TBI. Of these, 64 were mild. On ly 3 of 59 comparisons that were made between TBI and control subjects were significant. A developmental communication disorder cluster was significantly more frequent in the TBI group. Autism and a pervasive d evelopmental disorder cluster were significantly more frequent in the control group. Conclusion: In a child psychiatry clinic, patients with a history of TBI are virtually indistinguishable from matched childre n without TBI. Caution should be exercised before attributing the chil d's problems, especially long-term problems, to the TBI unless the inj ury was severe or the child is exhibiting related phobic or posttrauma tic stress symptomatology.