Psychiatric Illness Following Traumatic Brain Injury in an Adult HealthMaintenance Organization Population

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Abstract
High rates of mood, psychotic, and substance abuse disorders followingtraumatic brain injury (TBI) have been found in hospitalized trauma and tertiarycare referral populations.1-5 Apopulation-based secondary analysis of the New Haven portion of the NationalInstitute of Mental Health Epidemiologic Catchment Area Study6 bySilver and colleagues examined patients at varying time points after self-reported"severe head injury that was associated with a loss of consciousness or confusion,"7(p937) making the TBI exposure susceptibleto recall bias. The study found that adjusted odds ratios (ORs) for all psychiatricdiagnoses except bipolar disorder were increased in the group reporting ahistory of head injury compared with the group reporting no history of headinjury. Data on injury severity and time since injury were not available.Few data exist on the longitudinal risk of psychiatric disorders in large,population-based ambulatory primary care settings following the entire spectrumof TBI severity, particularly mild TBI.

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