Neuropsychiatric consequences of traumatic brain injury: a comparison between two age groups

Abstract

Background: Neurobehavioural symptoms and certain psychiatric disorders are common after a traumatic brain injury (TBI). Relatively few studies have investigated the effect of age upon these outcomes.

Aim: Our aim was to compare the rates of neurobehavioural symptoms and psychiatric disorders between 18-65 year old and over 65 year old patients with TBI.

Method: 120 adults aged 18 to 65 years and 45 adults over 65 years of age who were admitted to a hospital following a TBI were assessed for neurobehavioural symptoms and psychiatric disorders one year after the injury.

Results: Our estimate suggested that a higher proportion of 18-65 year old patients (32%) had ICD-10 psychiatric disorders according to the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) interview compared with patients over 65 years of age (16%). Similarly, the ICD-10 depressive disorder was more common among the younger patients (16%) than the older group of patients (11%). None of these differences were statistically significant. However, a multiple regression analysis revealed that among other risk factors, a younger age was significantly associated with the presence of a psychiatric disorder. Also, a significantly higher rate of psychiatric caseness was detected among the younger age group using screening instruments such as the General Health Questionniare-28 (GHQ-28) (p < 0.01) and the Clinical Interview Schedule-Revised (CIS-R) (p < 0.01). The rates of individual neurobehavioural symptoms varied significantly between the two age groups. The most prevalent symptoms in 18-65 year olds were irritability (37%) and sleep problems (37%). In the older group of patients the most prevalent symptoms were poor memory (40%), dependence (38%) and slowness in thinking (33%).

Conclusion: 18-65 year old patients are likely to be at a greater risk of psychiatric morbidity following TBI than over 65 year olds whereas neurobehavioural symptoms are prevalent in both age groups.