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Behavioral and Psychiatric Comorbidities of TBI

  • Robert L. Collins
  • Hannah L. Combs
  • Shannon R. Miles
  • Nicholas J. Pastorek
  • Andra Teten Tharp
  • Thomas A. KentEmail author
Chapter

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.

Keywords

Impulsive aggression Postconcussion syndrome Suicide Posttraumatic stress disorder Depression Traumatic brain injury Military Veteran Aggression 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Robert L. Collins
    • 1
  • Hannah L. Combs
    • 2
  • Shannon R. Miles
    • 3
  • Nicholas J. Pastorek
    • 4
  • Andra Teten Tharp
    • 5
  • Thomas A. Kent
    • 6
    Email author
  1. 1.Neurology Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Department of Neurology, Baylor College of MedicineHoustonUSA
  2. 2.Baylor College of Medicine, Department of NeurologyHoustonUSA
  3. 3.James A. Haley Veterans Hospital, HSR & D Center of Innovation on Disability and Rehabilitation Research (CINDRR)TamplaUSA
  4. 4.Michael E. DeBakey VA Medical Center, Department of Rehabilitation and Extended Care LineHoutsonUSA
  5. 5.Baylor College of Medicine, Department of Psychiatry and Behavioral SciencesHoustonUSA
  6. 6.Institute of Biosciences and Technology, Texas A & M Health Science Center, Department of Neurology, Houston Methodist HospitalHoustonUSA

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