Citation

Wortzel HS, Granacher RP. J. Am. Acad. Psychiatry Law 2015; 43(4): 499-505.

Affiliation

Dr. Wortzel is Director of Neuropsychiatric Consultation Services for the Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver Veterans Medical Center, Denver CO, and the Michael K. Cooper Professor of Neurocognitive Disease, Associate Professor of Psychiatry, Neurology, and Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Denver, CO. Dr. Granacher is Clinical Professor of Psychiatry, University of Kentucky College of Medicine, Lexington, KY. Support for this work was provided in part by the Veterans Health Administration's VISN-19 MIRECC (to H.S.W.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs.

Copyright

(Copyright © 2015, American Academy of Psychiatry and the Law, Publisher American Academy of Psychiatry and the Law)

DOI

unavailable

PMID

26668228

Abstract

Traumatic brain injury (TBI) involves a wide range of potential neuropsychiatric outcomes, from death or profound impairment to full and fast recovery. This circumstance has contributed to an atmosphere with considerable potential for both clinical confusion and unjustified medicolegal outcomes. Given that mild (m)TBI accounts for most (∼80%) TBI events and is generally associated with an excellent prognosis, the risk for erroneous clinical formulations and unmerited legal outcomes seems particularly high in cases involving mTBI. In this article, we summarize the recent results published by the International Collaboration on Mild Traumatic Brain Injury Prognosis (ICMTBIP) and the new approach of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, to TBI, and we explore the clinical and medicolegal implications. Symptoms that emerge after mTBI remain nonspecific, and potential etiologies are diverse. Clinicians and medicolegal experts should be familiar with the natural history of mTBI, able to recognize atypical outcomes, and willing to search for alternative explanations when confronted with persistent or severe impairment.

Language: en