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Traumatic brain injury in a child psychiatry inpatient population: a controlled study
J E Max1, A Sharma, M I Qurashi
1Department of Psychiatry, University of Iowa, Iowa City 52242, USA.
Insights
Children with a history of traumatic brain injury (TBI) admitted to child psychiatry inpatient units were similar to those without TBI. This suggests TBI may not be the sole cause of psychiatric issues unless severe or accompanied by specific symptoms.
Area of Science:
- Child and Adolescent Psychiatry
- Neuropsychology
- Pediatric Neurology
Background:
- Traumatic brain injury (TBI) is a significant concern in child development and psychiatric disorders.
- Previous research suggested potential links between TBI and psychiatric conditions in outpatients.
- The impact of TBI on child psychiatry inpatients requires further investigation.
Purpose of the Study:
- To determine if children with a history of TBI admitted to inpatient psychiatric care resemble matched children without TBI.
- To extend prior findings from child psychiatry outpatients to the inpatient population.
- To assess the influence of mild TBI on psychiatric presentations in hospitalized children.
Main Methods:
- A retrospective chart review of consecutively admitted child psychiatry inpatients over five years.
- Matching TBI cases with control subjects based on age, sex, race, and social class.
- Comparison of Axis I and II diagnoses, diagnostic clusters, special education service utilization, and IQ scores.
Main Results:
- Of 694 admitted patients, 56 (8.1%) had a documented history of TBI.
- No significant differences were found in over 50 compared variables between TBI and control groups.
- Children with TBI were statistically indistinguishable from their matched counterparts without TBI.
Conclusions:
- In child psychiatry inpatient settings, TBI history did not differentiate patients from non-TBI controls.
- Attributing psychiatric problems, particularly long-term ones, to TBI should be done cautiously.
- Consideration of injury severity and specific phobic or posttraumatic stress symptoms is crucial when linking TBI to psychiatric issues.
Objective:
To extend our findings from child psychiatry outpatients to child psychiatry inpatients regarding the similarity of children with a history of traumatic brain injury (TBI), particularly mild TBI, to matched children without such a history.
Method:
This is a chart review of patients consecutively admitted to a child psychiatry inpatient unit over a 5-year period. Children with TBI were matched by age, sex, race, and social class to children with no history of TBI. Axis I and II diagnoses and diagnostic clusters and use of special education services and IQ scores were compared.
Results:
Fifty-six (8.1%) of 694 consecutive patients admitted had a definite TBI. Not one of more than 50 variables compared between TBI and control subjects was significantly different.
Conclusion:
In a child psychiatry inpatient unit, patients with a history of TBI were virtually indistinguishable from matched children without TBI. Caution should be exercised before attributing the child's problems, especially long-term problems, to the TBI unless the injury was severe or the child is exhibiting related phobic or posttraumatic stress symptomatology.