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Behavioral and Psychiatric Comorbidities of TBI

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Abstract

Traumatic brain injury (TBI) is associated with a variety of behavioral consequences, including symptoms of depression, anxiety, aggression, and impulse control and overlaps with many of the symptoms of posttraumatic stress and posttraumatic stress disorder. There are many challenges to researchers and clinicians, including heterogeneity of the injury, distinguishing premorbid characteristics from the consequences of the TBI, lack of specificity in diagnostic criteria, and the absence of systematic therapeutic trials. In this chapter, we present an overview of the literature on psychiatric and behavioral consequences of TBI, highlighting those studies that investigate the incidence of these conditions, contribution of premorbid functioning to subsequent symptoms, and characteristics of mild TBI (frequently referred to as concussion) that provide clues to distinguishing it from other psychiatric comorbidities. Our analysis of the available literature suggests that in some but not all cases, TBI may diminish inhibitory control over certain behaviors, while in others there may be an exacerbation of clinical expression of psychiatric symptoms. Potential treatments need to consider the possibility of adverse events in patients who have suffered a TBI, and prospective trials should be encouraged.

This material is the result of work supported with resources and the use of facilities at the Michael E. DeBakey Veterans Affairs Medical Center (RLK, HLC, NP, TAK), the James A. Haley Veterans’ Hospital (SM). SH was supported in part by the Consortium to Alleviate PTSD (CAP) award numbers W81XWH-13-2-0065 from the U.S. Department of Defense, Defense Health Program, Psychological Health and Traumatic Brain Injury Research Program (PH/TBI RP), and I01CX001136-01 from the U.S. Department of Veterans Affairs, Office of Research & Development, Clinical Science Research & Development Service. TAK was supported in part by NIH R01 NS094535 and the Welch Foundation grant BE-0048. The contents do not represent the views of the Department of Veterans Affairs or the United States Government.

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Author notes

  1. Robert L. Collins, Hannah L. Combs, and Shannon R. Miles contributed equally to this work.

Authors and Affiliations

  1. Neurology Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Department of Neurology, Baylor College of Medicine, Houston, TX, USA

    Robert L. Collins

  2. Baylor College of Medicine, Department of Neurology, Houston, TX, USA

    Hannah L. Combs

  3. James A. Haley Veterans Hospital, HSR & D Center of Innovation on Disability and Rehabilitation Research (CINDRR), Tampla, FL, USA

    Shannon R. Miles

  4. Michael E. DeBakey VA Medical Center, Department of Rehabilitation and Extended Care Line, Houtson, TX, USA

    Nicholas J. Pastorek

  5. Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, TX, USA

    Andra Teten Tharp

  6. Institute of Biosciences and Technology, Texas A & M Health Science Center, Department of Neurology, Houston Methodist Hospital, Houston, TX, USA

    Thomas A. Kent

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  1. Robert L. Collins
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Correspondence to Thomas A. Kent .

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  1. The University of Tennessee Health Science Center, Memphis, TN, USA

    Jack W. Tsao

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Collins, R.L., Combs, H.L., Miles, S.R., Pastorek, N.J., Tharp, A.T., Kent, T.A. (2020). Behavioral and Psychiatric Comorbidities of TBI. In: Tsao, J. (eds) Traumatic Brain Injury. Springer, Cham. https://doi.org/10.1007/978-3-030-22436-3_14

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