Epidemiology and Natural History of Psychiatric Disorders After TBI
Open accessAbstract
This article outlines the epidemiology of psychiatric disorders in individuals with traumatic brain injury (TBI), with a focus on DSM axis I disorders diagnosed on the basis of structured clinical interview. The epidemiology of psychiatric disorders in the general population is described as a basis for understanding the disorders that occur before and after TBI. For each disorder category, including mood disorders, anxiety disorders, acute stress disorder, posttraumatic stress disorder (PTSD), substance use disorders, psychotic disorders, eating disorders, somatoform disorders, and adjustment disorders, the evidence from retrospective, cross-sectional and prospective studies is reviewed, showing the frequency, time course, and predictors of the disorders. Studies show elevated rates of depressive and anxiety disorders after TBI, most commonly major depressive disorder and PTSD, usually emerging in the first year postinjury but with delayed onset in severe injury cases. Although individuals with a preinjury history are more likely to develop these disorders, the nature of the disorders may change after injury, and novel psychiatric disorders are also common. Even though the frequency of anxiety disorders diminishes over the years postinjury, depressive disorders are more persistent during postinjury years. Substance use-while high before injury-declines after injury. The frequency of psychotic, eating, somatoform, and adjustment disorders do not exceed population rates.
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An overall estimate of 70% of individuals with mTBI struggle with at least one psychiatric comorbidity.
“An overall estimate of 70% of individuals with mTBI struggle with at least one psychiatric comorbidity [65].”
From Frontal Pole Neuromodulation for Impulsivity and Suicidality in Veterans With Mild Traumatic Brain Injury and Common Co-Occurring Mental Health Conditions: Protocol for a Pilot Randomized Controlled Trial (2024) · cites this paper as [65]
The POST-TBI PSYCHIATRIC DISORDERS section (page unavailable) reports that 74.5% received a psychiatric diagnosis over five years, but that sample consisted predominantly of people with moderate to severe TBI, not mTBI. It also reports a 34.0% first-year rate for mild TBI in a medical-file review, so the approximately 70% figure is not supported as an overall estimate for mTBI. (LLM, conf=0.90)
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- Authors
- Ponsford, J., Alway, Y., & Gould, K. R.
- Affiliations
- Epworth Hospital (AU)
- Venue
- The Journal of Neuropsychiatry and Clinical Neurosciences
- Published
- 2018-10
- Volume
- 30
- Issue
- 4
- Pages
- 262-270
- ISSN
- 0895-0172 (ISSN-L)
- 1545-7222
- OpenAlex
- W2811513197
- Cited by
- 156
- References
- 54
- Citations by year
- 2026: 15 · 2025: 15 · 2024: 17 · 2023: 16 · 2022: 15 · 2021: 25 · 2020: 45 · 2019: 7 · 2018: 1
- FWCI
- 15.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neuropsychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Keywords
- traumatic brain injury, psychiatric comorbidity, mood disorders, major depressive disorder, anxiety disorders, post-traumatic stress disorder, acute stress disorder, substance use disorders, psychosis, eating disorders, somatoform disorders, adjustment disorder, natural history (disease), delayed onset
- MeSH terms
- Brain Injuries, Traumatic, Adult, Anxiety Disorders, Australia, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Stress Disorders, Post-Traumatic, Time Factors, Substance-Related Disorders
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