Neuropsychiatric problems after traumatic brain injury: unraveling the silent epidemic

Psychosomatics. 2009 May-Jun;50(3):198-205. doi: 10.1176/appi.psy.50.3.198.


Background: Traumatic brain injury (TBI) is a significant public health concern. According to the Centers for Disease Control and Prevention, about 1.4 million people in the United States sustain a TBI annually.

Objective: This review places particular emphasis on the current knowledge of effective treatment of TBI symptoms, and proposes directions for future research.

Results: Neuropsychiatric problems are more prevalent and longer-lasting in TBI patients than in the general population. About 40% of TBI victims suffer from two or more psychiatric disorders, and a similar percentage experience at least one unmet need for cognitive, emotional, or job assistance 1 year after injury. The entire spectrum of TBI severity, from mild to severe, is associated with an increase in psychiatric conditions.

Conclusion: Despite the high incidence of severe consequences of TBI, there are scarce empirical data to guide psychiatric treatment. Some approaches that have been helpful include cognitive and behavioral therapy and pharmacologic treatment. The authors list specific research recommendations that could further identify useful therapeutic interventions.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Anxiety Disorders / rehabilitation
  • Behavior Therapy*
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / epidemiology
  • Bipolar Disorder / psychology
  • Bipolar Disorder / rehabilitation
  • Brain Injuries / diagnosis
  • Brain Injuries / epidemiology*
  • Brain Injuries / psychology
  • Brain Injuries / rehabilitation*
  • Brain Injury, Chronic / diagnosis
  • Brain Injury, Chronic / epidemiology*
  • Brain Injury, Chronic / psychology
  • Brain Injury, Chronic / rehabilitation*
  • Cognitive Behavioral Therapy*
  • Combined Modality Therapy
  • Cross-Sectional Studies
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology
  • Depressive Disorder / rehabilitation
  • Disease Outbreaks*
  • Humans
  • Neurocognitive Disorders / diagnosis
  • Neurocognitive Disorders / epidemiology
  • Neurocognitive Disorders / psychology
  • Neurocognitive Disorders / rehabilitation
  • Patient Care Team
  • Prognosis
  • Psychotropic Drugs / adverse effects
  • Psychotropic Drugs / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome


  • Psychotropic Drugs