TOPLINE:

Traumatic intracranial hemorrhage (tICH) was associated with higher odds of experiencing subsequent psychiatric disorders in a new study, especially among younger patients. Overall, psychiatric disorders were reported in 17% of adults after tICH, 72% of whom experienced new psychiatric symptoms.

METHODOLOGY:

• An observational, retrospective cohort study included data of 385 adults with tICH (mean age, 61 years; 66.5% men) admitted to one neurosurgical emergency unit in Helsinki, Finland.
• Data for analysis were obtained from electronic patient charts of secondary hospital registers.
• Outcomes included diagnoses of psychiatric disorders and subsequent treatment in secondary-level psychiatric care from 2010 to 2019.
• Patients were followed until a new diagnosis of a psychiatric disorder at secondary-level care, death, or end of the study follow-up period. The median follow-up duration was 108 months.

TAKEAWAY:

• Among the 17% of patients with tICH who had psychiatric disorders during the follow-up period, 72% experienced new psychiatric disorders (median time to onset, 29.5 months) — and 54% of these had no previous psychiatric history. The most common psychiatric disorders were depression, anxiety, and intoxicating psychoactive substance use.
• Secondary-level psychiatric care was initiated in 53% of patients with psychiatric disorders, and 61% initiated new psychotropic medications ( median time to initiation, 8 months).
• Patients with psychiatric disorders were significantly younger than those without disorders (P < .001), and less frequently had larger (> 100 mL) tICH volumes (21% vs 44%; P = .001).
• A history of psychiatric medication use (P = .001) and lower Glasgow Coma Scale scores (P = .01) were independently associated with subsequent psychiatric treatment in secondary-level psychiatric care during the follow-up period.

IN PRACTICE:

“The extent of psychiatric disorders diagnosed at secondary level care after tICH…appears significant and their severity is prominent,” the investigators wrote.

“Most of the patients with psychiatric disorders were experiencing them for the first time in their life after a tICH,” they added. 

SOURCE:

This study was led by Janne Kinnunen, MD, Meilahti Hospital at the University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland. It was published online on October 18 in Acta Neurochirurgica.

LIMITATIONS:

Limitations included the study’s retrospective nature and single-center design — and that it focused on more severe head traumas, excluding mild traumatic brain injuries and injuries not requiring hospital admission, which limited the generalizability of the findings. The investigators did not differentiate between background diseases with neuropsychologic propensities for developing psychiatric sequelae, such as neurodegenerative disorders.

DISCLOSURES:

This study received state research funding from the Helsinki University Hospital. The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.