Psychiatric risk factors for traumatic brain injury

Objective: To examine the risk of sustaining a traumatic brain injury (TBI) associated with prior psychiatric conditions beyond that of fixed demographic variables.

Design: Retrospective cohort study of non-referred community-dwelling male US veterans.

Methods: Two-hundred and seventy-one individuals who sustained a TBI with altered consciousness were compared with 630 controls without a history of head injury, selected from a larger sample of 3766.

Results: Hierarchical logistic regression analyses were used to model odds ratios and 95% confidence intervals for the unique association between pre-existing psychiatric disorders and the likelihood of incurring a TBI while adjusting for demographic characteristics and other known predictor variables. Mood (odds ratio 2.48, 95% confidence interval 1.23-5.01), anxiety (OR 1.64, 95% CI 1.01-2.68) and conduct disorders (OR 1.66, 95% CI 1.16-2.38) increased the risk of head injury.

Conclusions: The pre-existence of psychiatric illness, particularly depression, anxiety and conduct disorder, increased the future risk of incurring a TBI. The implementation of early identification and treatment of psychiatric conditions may potentially lower risk and reduce yearly incidence rates of TBI.