Citation

Balan AB, Walz R, Diaz AP, Schwarzbold ML. Rev. Bras. Psiquiatr. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Associacao Brasileira de Psiquiatria)

DOI

10.1590/1516-4446-2020-1660

PMID

unavailable

Abstract

Although behavioral changes after traumatic brain injury (TBI) have been linked to work disability, research in the area is limited, especially in developing countries.1 In severe TBI, behavioral sequelae mainly include depression and personality changes. The latter is marked by varying levels of apathy, disinhibition, aggression, and affective lability.2 In a study published in the Brazilian Journal of Psychiatry,3 we found that a diagnosis of personality change due to severe TBI was associated with non-return to work independently from a range of sociodemographic, clinical and psychiatric variables. In the present study (Plataforma Brasil ethical approval 02832612.6.1001.0121), we expanded this investigation by examining the role of specific personality change symptoms in a new sample recruited three years later.

Forty-one survivors of severe TBI, who were working at the time of injury, were recruited from two intensive care units in the metropolitan area of Florianópolis, Brazil, and underwent psychiatric assessment during the chronic phase of the disease. Except for three cases, a close relative was available to describe the participants' behavior. Major depressive episode and substance abuse or dependence were diagnosed using the Mini International Neuropsychiatric Interview. Personality change was diagnosed according to DSM-5 criteria. Using the Overt Aggression Scale, aggression was defined as any incident of verbal or physical aggression in the last month. Disinhibition and general neuropsychiatric symptoms were defined using the Neuropsychiatric Inventory-Questionnaire. Apathy was defined using Robert's criteria and the Starkstein Apathy Scale. The participants had not engaged in vocational rehabilitation prior to assessment...

Language: en