Traumatic brain injury in a child psychiatry outpatient clinic: A controlled study

Author(s): Dunisch, D. L.

Journal/Book: J Amer Acad Child Adolesc Psy. 1997; 36: 351 West Camden St, Baltimore, MD 21201-2436. Williams & Wilkins. 404-411.

Abstract: Objective: To demonstrate the similarity of children with a history of traumatic brain injury (TBI), particularly mild TBI, to matched children without such a history, within a child psychiatry outpatient clinic. Method: This is a chart review of patients presenting to a child psychiatry outpatient clinic over a 3-year period. Children with TBI were matched by age, sex, race, and social class to children with no history of TBI. Axis I and II diagnoses, use of special education services, and IQ scores were compared. Results: Seventy-four (5.6%) of 1,333 consecutive clinic cases had a definite TBI. Of these, 64 were mild. Only 3 of 59 comparisons that were made between TBI and control subjects were significant. A developmental communication disorder cluster was significantly more frequent in the TBI group. Autism and a pervasive developmental disorder cluster were significantly more frequent in the control group. Conclusion: In a child psychiatry clinic, patients with a history of TBI are virtually indistinguishable from matched children without TBI. Caution should be exercised before attributing the child's problems, especially long-term problems, to the TBI unless the injury was severe or the child is exhibiting related phobic or posttraumatic stress symptomatology.

Note: Article Max JE, Univ Iowa Hosp & Clin, Dept Psychiat, 200 Hawkins Dr, 1876 Jpp, Iowa City,IA 52242 USA

Keyword(s): traumatic brain injury; children and adolescents; psychiatric outpatients; HEAD-INJURIES; SEQUELAE

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