Behaviour problems after brain injury: incidence and need for treatment

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Abstract
The aim of this study was to identify the incidence and nature of behaviour problems following severe head injury. All severe head injuries in a known population were identified from a three-year period. Sixteen patients were assessed for behavioural problems shortly after injury, while still in hospital. The relatives' judgements of behavioural change observed at home, for a total of 33 patients from three consecutive years, was collected to compare the extent of behavioural problems during the years following injury. More behavioural problems were reported at home, by families, than by nursing and therapy staff in hospital. Relatives identified behaviour change in about 80% of the patients and significant practical problems were reported at home in about half of all severely head-injured people. Symptoms appeared to be persistent and tended to worsen over a three-year period following the injury. In particular, aggressive behaviour increased. Behaviour change did not correlate with either age or the severity of the injury as measured by post-traumatic amnesia. The results of this study draw attention to the need for treatment and support for the families of brain-injured patients showing behavioural disturbance, at home, after they have been discharged from hospital.