Traumatic brain injury in children and adolescents: Psychiatric disorders in the first three months

Objective: To assess predictive factors of psychiatric outcome in the first 3 months after traumatic brain injury (TBI) in children and adolescents. Method: Subjects were children aged 6 to 14 years at the time they were hospitalized after TBI. The study used a prospective follow-up design. Assessments of preinjury psychiatric, behavioral, adaptive functioning, family functioning, and family psychiatric history status were conducted. Severity of injury was assessed by standard clinical scales and neuroimaging was analyzed. The outcome measure was the development of a psychiatric disorder, never before present ('novel') in a subject during the first 3 months after the TBI. Results: Fifty subjects enrolled, and the analyses focused on 37 subjects followed up at 3 months. Increasing severity of injury, presence of a lifetime psychiatric disorder, family psychiatric history, family dysfunction, and lower socioeconomic class/preinjury intellectual function predicted the development of a 'novel' psychiatric disorder in the first 3 months of follow-up. Conclusions: These data suggest that there are children, identifiable through clinical assessment, at increased risk for development of psychiatric disorders in the first 3 months after TBI.