Long-term psychiatric outcomes following traumatic brain injury: A review of the literature

OBJECTIVE: To determine the relationship between traumatic brain injury (TBI) and long-term psychiatric health outcomes, occurring 6 months or more after TBI. PARTICIPANTS: Not applicable. DESIGN: Systematic review of the published, peer-reviewed literature. PRIMARY MEASURES: Not applicable. RESULTS: We identified studies that examined psychiatric disorders following TBI. There was sufficient evidence of an association between TBI and depression and similarly compelling evidence of an association between TBI and aggression. There was limited/suggestive evidence of an association between TBI and subsequent completed suicide, decreased alcohol and drug use compared to preinjury levels, and psychosis. While there was also limited/suggestive evidence for posttraumatic stress disorder (PTSD) in military populations with TBI, there was inadequate evidence to reach a conclusion about whether TBI was associated with PTSD in civilian populations. CONCLUSION: TBI is associated with a wide range of psychiatric disorders among individuals surviving at least 6 months. The association between mild TBI and PTSD seems to differ in military and civilian populations.