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Journal of Head Trauma Rehabilitation:
doi: 10.1097/HTR.0b013e318287f894
Original Articles

Psychotic Symptoms as Manifestations of the Posttraumatic Confusional State: Prevalence, Risk Factors, and Association With Outcome

Sherer, Mark PhD; Yablon, Stuart A. MD; Nick, Todd G. PhD

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Objectives: To (1) determine factors associated with psychotic-type symptoms in persons with moderate or severe traumatic brain injury (TBI) during early recovery and (2) investigate the prognostic significance of early psychotic-type symptoms for patient outcome.

Setting: Acute neurorehabilitation inpatient unit.

Participants: A total of 168 persons with moderate or severe TBI were admitted for inpatient rehabilitation. Of these, 107 had psychotic-type symptoms on at least 1 examination. One-year productivity outcome was available for 87 of the 107 participants.

Design: Prospective, inception cohort, observational study.

Main Measures: Confusion Assessment Protocol, productivity outcome at 1 year postinjury.

Results: Presence of sleep disturbance, a shorter interval from admission to assessment, and greater cognitive impairment were associated with a greater incidence of psychotic-type symptoms. Younger age, more years of education, and lower frequency and severity of psychotic-type symptoms were associated with a greater likelihood of favorable productivity outcome.

Conclusions: We identified risk factors for the occurrence of psychotic-type symptoms and extended previous findings regarding the significance of these symptoms for outcome after TBI. These findings suggest that improved sleep in early TBI recovery may decrease the occurrence of psychotic-type symptoms.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins


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