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Neurobehavioural symptoms one year after a head injury

Published online by Cambridge University Press:  02 January 2018

Shoumitro Deb ,
Ita Lyons  and
Charis Koutzoukis
Shoumitro Deb*
Affiliation:
Division of Psychological Medicine, University of Wales College of Medicine, Cardiff
Ita Lyons
Affiliation:
Division of Psychological Medicine, University of Wales College of Medicine, Cardiff
Charis Koutzoukis
Affiliation:
Division of Psychological Medicine, University of Wales College of Medicine, Cardiff
*
Dr S. Deb, Division of Psychological Medicine, University of Wales College of Medicine, Heath Park, Cardiff CF4 4XN. Tel: 01222 562323; Fax: 01222 555047; e-mail: [email protected]
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Abstract

Background

Neurobehavioural symptoms are common immediately after a minor head injury but have not been studied one year after the injury.

Aims

To estimate the rate and pattern of neurobehavioural symptoms one year after a head injury of varying severity.

Method

Adults who had been hospitalised after a head injury (n=196, 164 of whom had a face-to-face interview) and showed indirect evidence of brain assault were assessed for the presence of neurobehavioural symptoms with the help of a behaviour rating scale.

Results

About 40% had three or more symptoms. Individual symptoms varied among 3% (social disinhibition), 15% (lack of initiative) and 35% (irritability) of the cohort. Premorbid factors such as lower social class and lower educational achievement, head-injury-related factors such a low Glasgow coma score, and outcome-related factors such as the presence of a disability according to the Edinburgh Rehabilitation Status Scale and psychiatric caseness according to the Clinical Interview Schedule–Revised, significantly influenced the rate and the pattern of behavioural symptoms. The pattern of symptoms varied between age groups and according to the severity of the head injury.

Conclusions

A significant proportion of patients with varying degrees of severity of head injury showed behavioural symptoms after one-year of head injury.

Type
Papers
Information
The British Journal of Psychiatry , Volume 174 , Issue 4 , April 1999 , pp. 360 - 365
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

Study funded by the Welsh Office.

References

Affleck, J. W., Aitken, R. C. B., Hunter, J. A. A., et al (1988) Rehabilitation status: a measure of medicosocial dysfunction. Lancet, i, 230–233.Google Scholar
Bebbington, P. E. & Nayani, T. (1995) The Psychosis Screening Questionnaire. International Journal of Methods in Psychiatric Research, 5, 11–19.Google Scholar
Bohnen, N., Twijnstra, A. & Jolles, J. (1992) Post-traumatic and emotional symptoms in different subgroups of patients with mild head injury. Brain Injury, 6, 481–486.CrossRefGoogle ScholarPubMed
Cicerone, K. D. & Kalmar, K. (1995) Persistent post-concussion syndrome; the structure of subjective complaints after mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 10, 1–17.CrossRefGoogle Scholar
Deb, S. (1999) ICD–10 codes detect only a proportion of all head injury admissions. Brain Injury, in press.CrossRefGoogle Scholar
Deb, S., Lyons, I. & Koutzoukis, C. (1998) Neuropsychiatric sequelae one year after a minor head injury. Journal of Neurology, Neurosurgery & Psychiatry 65, 899–902.Google Scholar
Deb, S., Lyons, I. & Koutzoukis, C., et al (1999) Rate of psychiatric illness 1 year post traumatic brain injury. American Journal of Psychiatry, 156, 374–378.Google Scholar
Fenton, G., McClelland, R., Montgomery, A., et al (1993) The postconcussional syndrome. Social antecedents and psychological sequelae. British Journal of Psychiatry, 162, 493–497.CrossRefGoogle ScholarPubMed
Foistein, M. F., Foistein, S. E. & McHugh, P. R. (1975) “Mini-Mental State”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 89–198.Google Scholar
Gouvier, W. D., Uddo-Crane, M. & Brown, L. M. (1988) Base rates of post-concussional symptoms. Archives of Clinical Neuropsychology, 3, 273–278.Google Scholar
Jennett, B. & Bond, M. (1975) Assessment of outcome after severe brain damage: a practical scale. Lancet, i, 480–485.Google Scholar
Jennett, B., Snoek, J., Bond, M. R., et al (1981) Disability after severe head injury: observations on the use of the Glasgow Outcome Scale. Journal of Neurology, Neurosurgery and Psychiatry, 44, 285–293.CrossRefGoogle ScholarPubMed
Levin, H. S., Mattis, S., Ruff, R. M., et al (1987) Neurobehavioural outcome following minor head injury: a three centre study. Journal of Neurology. Neurosurgery and Psychiatry. 66, 234–243.Google Scholar
Lewis, G., Pelosl, A. J., Araya, R. C., et al (1992) Measuring psychiatric disorder in the community: a standardised assessment for use by lay interviewers. Psychological Medicine, 22, 465–486.Google Scholar
Lishman, W. A. (1988) Physiogenesis and psychogenesis in the ‘post-concussional syndrome’. British Journal of Psychiatry. 153, 460–469.Google Scholar
McClelland, R. J., Fenton, G. W. & Rutherford, W. (1994) The post-concussional syndrome revisited. Journal of the Royal Society of Medicine, 87, 508–510.Google Scholar
Medical Disability Society (1988) The Management of Traumatic Brain Injury London: Royal College of Physicians.Google Scholar
Meltzer, H., Gill, B., Petticrew, M., et al (eds) (1995) The Prevalence of Psychiatrie Morbidity Among Adults Living in Private Households: OPCS Survey of Psychiatric Morbidity in Great Britain. London: HMSO.Google Scholar
Nelson, M. E. (1982) National Adult Reading Test (NART). Windsor: NFER-Nelson.Google Scholar
Norušis, M. J. (1993) SPSS for Windows Base System Users' Guide. Release 6. 0. Chicago, IL: SPSS Inc.Google Scholar
Ruther ford, W., Merrett, J. D. & McDonald, J. R. (1978) Symptoms at one year following concussion from a minor head injury. Injury, 10, 225–230.CrossRefGoogle Scholar
Truell, J. L., Brooks, D. N., Portagase, C., et al (1994) A European chart for evaluation of patients with traumatic brain injury. In Brain Injury and Neuropsychological Rehabilitation: International Perspectives, pp. 281–291. London: Lawrence Erlbaum.Google Scholar
Wing, J. K. Babor, T., Brugha, T., et al (1990) SCAN: Schedules for Clinical Assessment on Neuropsychiatry. Archives of General Psychiatry, 47, 586–593.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to Their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
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