Psychiatric Morbidity in Patients with Traumatic Brain Injury

INTRODUCTION: Traumatic brain injury is one of the most common causes for high rates of mortality, morbidity and disability. It has been named as ‘silent epidemic’. India has the highest accident rates per vehicle in the world. The rehabilitation needs for it, is increasing. Apart from its physical effects, its psychiatric effects impair the social life and it is underdiagnosed and undertreated. It is therefore essential to look for it, for limiting the disability. It refers to the external force applied over the brain that causes permanent or temporary dysfunction. It is a universal health problem. AIMS AND OBJECTIVES: 1. To assess the prevalence of psychiatric disorders in patients with traumatic brain injury. 2. To assess its correlation with radiological finding. MATERIALS AND METHODS: SUBJECTS: 100. STUDY PLACE-Department of neurosurgery, Chennai. DURATION: 6 months from the date of approval of ethical committee. STUDY DESIGN: Cross Sectional Study. INCLUSION CRITERIA: 1. Patients attending outpatient and inpatient in neurosurgery department with history of head trauma 2. Patient showing radiological signs of brain damage through trauma. 3. age > 18 years. 4. both men and women. EXCLUSION CRITERIA: 1. Psychiatric illness before brain injury 2. Neurological disorders before brain injury 3. Patient having gross cognitive deficits making interview difficult. RESULTS: The protocol was approved by institutional ethics committee. Written informed consent was obtained from both the patients and the accompanying person. After applying the inclusion and exclusion criteria, total of 100 patients were taken by random sampling. Socio demographic details were obtained initially. They were assessed for the presence of psychiatric illness with MINI plus scale and when they fit into any of the psychiatric complaint scales were given to assess the severity of illness. CONCLUSION: In the treatment of head injury, apart from the treatment of physical symptoms, It is also important to treat psychiatric symptoms because psychiatric comorbidity delays the social and functional outcome of the patient. Most of it had been missed by clinicians and it affects the prognosis of the patient, so it is essential to identify the risk factors, understanding the clinical features for better treatment of the patient. Not a single can predict the risk of psychiatric comorbidity and also found it has no relationship with the severity and laterality of lesions consistently. Treatment of the illness involves a multi disciplinary approach with the psychiatrist in liaison with neurosurgeon and family. Treatment should follow from a clearly articulated diagnostic scheme and should be time limited and re-evaluated in the presence of poor or incomplete response