PSYCHIATRIC-DISORDERS IN CHILDREN AND ADOLESCENTS AFTER SEVERE TRAUMATIC BRAIN INJURY - A CONTROLLED-STUDY

Objective: To study psychiatric and behavioral morbidity associated wi th severe traumatic brain injury (TBI). Method: A consecutive series ( n = 24) of children aged 5 through 14 years whet suffered a severe TBI were matched to subjects who sustained a mild TBI and to a second mat ched group who sustained an orthopedic injury with no evidence of TBI. Standardized psychiatric, behavioral, and neuroimaging assessments we re conducted on average 2 years after injury. Results: Severe TBI was associated with a significantly higher rate of current.''novel'' psych iatric disorders (15/24; 63%) compared with children with mild TBI (5/ 24; 21%) and orthopedic injury (1/24; 4%). Higher effect sizes were ev ident for child and adolescent self-report of internalizing symptoms r ather than externalizing symptoms, for parents' report of overall beha vior and internalizing symptoms rather than externalizing symptoms, an d for teachers' reports of overall behavior and externalizing symptoms rather than internalizing symptoms. Conclusions: Severe TBI is a prof ound risk factor for the development of a psychiatric disorder. Surviv ors should be assessed for organic personality syndrome, which is the most common psychiatric disorder after this type of injury.