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

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.

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.

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.

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%).

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.