Prevalence and predictors of affective lability after paediatric traumatic brain injury

Area of Science:

• Neuroscience
• Paediatric Neurology
• Psychiatry

Background:

• Severe traumatic brain injury (TBI) in children frequently leads to lasting affective and behavioral issues.
• Affective lability, characterized by rapid mood swings, is a recognized but understudied consequence of paediatric TBI.

Purpose of the Study:

• To determine the prevalence and characteristics of affective lability in children one year after severe TBI.
• To identify risk factors associated with the development of affective lability post-TBI.

Main Methods:

• Ninety-seven children with severe TBI were assessed one year post-injury.
• The Children's Affective Lability Scale (CALS) was used to measure affective lability.
• Demographic, clinical, and brain lesion data, including orbitofrontal cortex damage, were collected.

Main Results:

• Affective lability significantly increased post-TBI, with many children showing marked elevations in CALS scores.
• Common manifestations included anxiety, silliness, dysphoria, and irritability, with irritability and temper outbursts being most severe.
• Risk factors included pre-existing affective lability, psychosocial adversity, and orbitofrontal cortex damage. Post-injury ADHD diagnosis was common.

Conclusions:

• Affective lability is a frequent outcome of paediatric severe TBI, often presenting as irritability and unpredictable outbursts.
• Early identification and intervention are essential for mitigating negative psychiatric sequelae and improving long-term outcomes in affected children.