Journal:Psychiatric Clinics of North America
Year, Volume, Issue, Page(s):14, 1, 37, 13-29
Article provides an overview of the evaluation and management of disorders of mood following traumatic brain injury (TBI). Methods of assessing mood disorders are described briefly, and the importance of considering the differential diagnoses for these clinical phenomena is highlighted. Depressive disorders are the most common neuropsychiatric sequels of TBI. Mania, hypomania, and mixed mood states are less frequent but serious complications of TBI. In many respects, the evaluation and management of these conditions is similar to that provided to persons with primary (idiopathic) mood disorders. Mood disorders are highly comorbid with anxiety, substance misuse, and other behavioral alterations like impulsivity and aggression. Furthermore, once developed, they may have a chronic and refractory course. The functional repercussion of these disorders is huge, affecting the rehabilitation process as well as the long-term outcome of patients with TBI. The current treatment options are based on current standards of practice rather that empirically based controlled treatment trials. Randomized, double-blind, placebo-controlled trials are needed to establish the most effective treatments for the variety of mood disorders associated with TBI.