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Diagnostic and treatment challenges in traumatic brain injury patients with severe neuropsychiatric symptoms: insights into psychiatric practice.

Lauterbach MD, Notarangelo PL, Nichols SJ, Lane KS, Koliatsos VE - Neuropsychiatr Dis Treat (2015)

Bottom Line: Data analysis indicates that mood stabilization was a key concern, often requiring aggressive pharmacological management.Cognitive dysfunction was a problem for the majority of patients, but was only medicated in a third, due to poor efficacy or behavioral side effects.The co-occurrence of multiple TBI-related symptoms and diagnoses in this patient cohort emphasizes the need for individualized psychopharmacological approaches and interventions.

View Article: PubMed Central - PubMed

Affiliation: The Neuropsychiatry Program at Sheppard Pratt, Sheppard Pratt Health System, Baltimore, MD, USA.

ABSTRACT
Traumatic brain injury (TBI) causes a variety of neuropsychiatric problems that pose diagnostic and treatment challenges for providers. In this report, we share our experience as a referral neuropsychiatry program to assist the general psychiatrist when adult TBI patients with psychiatric symptoms present for evaluation and treatment. We completed a retrospective study of patients with moderate-to-severe TBI and severe neuropsychiatric impairments. We collected information on demographics, nature of injury, symptomatology, diagnoses, and treatments. Data analysis indicates that mood stabilization was a key concern, often requiring aggressive pharmacological management. Cognitive dysfunction was a problem for the majority of patients, but was only medicated in a third, due to poor efficacy or behavioral side effects. The co-occurrence of multiple TBI-related symptoms and diagnoses in this patient cohort emphasizes the need for individualized psychopharmacological approaches and interventions.

No MeSH data available.


Related in: MedlinePlus

Frequency of neuropsychiatric symptoms (n=60).
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f2-ndt-11-1601: Frequency of neuropsychiatric symptoms (n=60).

Mentions: Figure 1 shows the primary and any co-occurring diagnoses used in our patient population. The vast majority of patients were diagnosed with some type of cognitive disorder such as dementia or amnestic disorder (92%) or a personality change (88%). A majority of patients were diagnosed with mood disorders (67%), whereas a minority of patients were diagnosed with a psychotic disorder (20%). Specific symptoms experienced by patients in our sample are outlined in Figure 2. Ninety five percent of patients experience cognitive dysfunction (n=57), 87% (n=52) experience personality or behavioral changes, 68% (n=41) had symptoms of a mood disorder, 30% (n=18) had psychotic symptoms, and 83% (n=50) exhibited motor or sensory disturbances.


Diagnostic and treatment challenges in traumatic brain injury patients with severe neuropsychiatric symptoms: insights into psychiatric practice.

Lauterbach MD, Notarangelo PL, Nichols SJ, Lane KS, Koliatsos VE - Neuropsychiatr Dis Treat (2015)

Frequency of neuropsychiatric symptoms (n=60).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494623&req=5

f2-ndt-11-1601: Frequency of neuropsychiatric symptoms (n=60).
Mentions: Figure 1 shows the primary and any co-occurring diagnoses used in our patient population. The vast majority of patients were diagnosed with some type of cognitive disorder such as dementia or amnestic disorder (92%) or a personality change (88%). A majority of patients were diagnosed with mood disorders (67%), whereas a minority of patients were diagnosed with a psychotic disorder (20%). Specific symptoms experienced by patients in our sample are outlined in Figure 2. Ninety five percent of patients experience cognitive dysfunction (n=57), 87% (n=52) experience personality or behavioral changes, 68% (n=41) had symptoms of a mood disorder, 30% (n=18) had psychotic symptoms, and 83% (n=50) exhibited motor or sensory disturbances.

Bottom Line: Data analysis indicates that mood stabilization was a key concern, often requiring aggressive pharmacological management.Cognitive dysfunction was a problem for the majority of patients, but was only medicated in a third, due to poor efficacy or behavioral side effects.The co-occurrence of multiple TBI-related symptoms and diagnoses in this patient cohort emphasizes the need for individualized psychopharmacological approaches and interventions.

View Article: PubMed Central - PubMed

Affiliation: The Neuropsychiatry Program at Sheppard Pratt, Sheppard Pratt Health System, Baltimore, MD, USA.

ABSTRACT
Traumatic brain injury (TBI) causes a variety of neuropsychiatric problems that pose diagnostic and treatment challenges for providers. In this report, we share our experience as a referral neuropsychiatry program to assist the general psychiatrist when adult TBI patients with psychiatric symptoms present for evaluation and treatment. We completed a retrospective study of patients with moderate-to-severe TBI and severe neuropsychiatric impairments. We collected information on demographics, nature of injury, symptomatology, diagnoses, and treatments. Data analysis indicates that mood stabilization was a key concern, often requiring aggressive pharmacological management. Cognitive dysfunction was a problem for the majority of patients, but was only medicated in a third, due to poor efficacy or behavioral side effects. The co-occurrence of multiple TBI-related symptoms and diagnoses in this patient cohort emphasizes the need for individualized psychopharmacological approaches and interventions.

No MeSH data available.


Related in: MedlinePlus