[Psychosocial sequelae after severe head injury. Interviews with patients and their relatives in comparison]

Head injury patients often suffer from psychosocial sequelae in the long-term. Since patient reports are regarded as little reliable due to lack of awareness, we compared the patients' to the relatives' view of such sequelae. By means of a semi-structured interview, 37 patients and their relatives were investigated on average 4.4 years after severe head injury. Psychosocial and neuropsychological effects were markedly severe in most cases. However, patients' compared to relatives' perspectives differed significantly only regarding report of aggressive-disinhibited behaviour of the patients, which was more often reported on by the relatives than by the patients themselves. This difference was also found in respect of pre-injury behaviour. Surprisingly, in six patients "positive" psychosocial sequelae were reported. For example, a patient said he had become more tender and more serious. Residual morphological findings in these six patients were either rather minor, or marked left-brain lesions. We conclude that the patients' significant other signs should be included in diagnostic and therapeutic efforts of rehabilitation procedures. Since besides neuropsychological factors psychosocial factors seem to influence outcome after brain injury, psychotherapeutic techniques should be more intensively studied in treatment of head injury patients.