Psychosis and injury-a difficult conundrum

Psychosis and injury-a difficult conundrum

February 15, 2019

The issue of the relationship between psychosis and injury has always been difficult for psychiatrists to resolve. In general, my own view is that if there is a very close temporal relationship between the injury and the psychosis there could well be a relationship. Complications include premorbid symptoms, cannabis use after the injury and a previous history of psychosis. The matter is a little clearer with regard to traumatic brain injury.

The research literature in relation to psychosis following traumatic brain injury reveals that there is a causal link between the two. Some of the significant findings are:

• Psychosis developing following traumatic brain injury is three times more prevalent than psychosis developing within the general population.(Batty, R.)
• There is generally a latency period to the onset of psychosis, ranging from within the first year to even ten years post-head injury. ( Fujii, D.)
• Onset of psychosis is generally been in the age range of 20 to 30 years, but reports have also been noted outside this range, including in the teen years. ( Fujii, D.)
• There is an increased risk of developing schizophrenia following traumatic brain injury if there is a genetic predisposition to psychosis. (Molloy, C.)
• Studies are reports of the potential for psychosis increases with the severity of the traumatic brain injury. ( Fujii, D.)
• There is a greater incidence of psychosis with frontal and temporal lobe damage. ( Fujii, D.)

References

Batty, R., et al. (2013). Psychosis Following Traumatic Brain Injury. Brain Impairment. 14, 21-41

Fujii, D and Fujii, D. (2012). Psychotic Disorder due to Traumatic Brain Injury: Analysis of Case Studies in the Literature. The Journal of Neuropsychiatry and Clinical Neurosciences.24, 278-289.

Molloy, C, Conroy, R, Cotter, D, and Cannon, M

Is Traumatic Brain Injury A Risk Factor for Schizophrenia? A Meta-Analysis of Case-Controlled Population-Based Studies: Schizophr Bull. 2011 Nov; 37(6): 1104–1110.

 

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