Behavioral problems and psychological alterations after TBI: 10 years of clinical experience in a rehabilitation centre

Vestri Alec, Baccega Alice, Silvia Pizzighello, Francesca Peruch, Sara Piccoli, Marina Zettin

IRCCS E.Medea – Sede di Pieve di Soligo

Centro Puzzle – Torino

Introduction. Traumatic Brain Injury (TBI) may impact very differently in the life of the victims depending on various factors, including the presence of psychological and behavioural problems in moderate and severe TBI (Lezak, 2012) and also in mild TBI (Carroll et al., 2004). In Italy there are few data about the psychological characeristics of TBI population. This study is based on the clinical experience of a post-acute rehabilitation centre for people who suffered from acquired cerebrolesion.

Method. Analysis from 1500 patients with acquired cerebrolesions accessed in the last 10 years in IRCCS E. Medea revealed a sample of 297 patients with TBI. We extracted data about distribution of any psychological alterations. The sample was composed by 64% of people under 35 years old, 84% males, 81% traumatized in traffic accidents.

Results. 60% of the sample had clinical report of clinical psychological or psychiatric symptoms. Among the sample with psychological or psychiatric symptoms: 47% of the patients had psychological disorders with behavioural problems; 41% had other psychological disorders without behavioural problems (depression, anxiety, apathy, DOC symptoms); 12% had problems with alcohol or drug addiction, sleep disorders, post-traumatic stress disorder, wandering. Among the behavioural problems: 59% concerned aggressive symptoms (most of the cases combined with irritability), 26% agitation (often combined with restlessness), 11% impulsivity, 4% dyscontrol.

Conclusions. Post-acute phase is crucial for the rehabilitation of people who suffered from TBI. Most of the patients revealed psychological disorders with a differentiated symptoms distribution. Interest about neuropsychology disorders cannot be aside from clinical psychology.

Riassunto tratto dal lavoro presentato nel 2012 al Workshop Europeo a Bressanone.