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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

Pharmacological interventions (n=60).
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f3-ndt-11-1601: Pharmacological interventions (n=60).

Mentions: Figure 3 details all pharmacological interventions utilized for this patient population. Non-antipsychotic mood stabilizers were utilized in 80% of cases (n=48), followed by antipsychotics used in 68% of cases (n=41) and antidepressants in 40% of these patients (n=24). Of the 40 patients with a mood disorder diagnosis, 55% (n=22) were prescribed a non-antipsychotic mood stabilizer alone, 25% (n=10) were prescribed a non-antipsychotic mood stabilizer combined with an antidepressant, and 20% (n=8) were prescribed an antidepressant alone. Ten percent of patients (n=6) were prescribed two non-antipsychotic mood stabilizers, whereas 42% (n=25) were prescribed both a non-antipsychotic and an antipsychotic mood stabilizer.


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)

Pharmacological interventions (n=60).
© Copyright Policy
Related In: Results  -  Collection

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

f3-ndt-11-1601: Pharmacological interventions (n=60).
Mentions: Figure 3 details all pharmacological interventions utilized for this patient population. Non-antipsychotic mood stabilizers were utilized in 80% of cases (n=48), followed by antipsychotics used in 68% of cases (n=41) and antidepressants in 40% of these patients (n=24). Of the 40 patients with a mood disorder diagnosis, 55% (n=22) were prescribed a non-antipsychotic mood stabilizer alone, 25% (n=10) were prescribed a non-antipsychotic mood stabilizer combined with an antidepressant, and 20% (n=8) were prescribed an antidepressant alone. Ten percent of patients (n=6) were prescribed two non-antipsychotic mood stabilizers, whereas 42% (n=25) were prescribed both a non-antipsychotic and an antipsychotic mood stabilizer.

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