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Alcohol misuse and mood disorders following traumatic brain injury.
Arch Gen Psychiatry. 2005 Jul; 62(7):742-9.AG

Abstract

CONTEXT

Alcohol abuse and/or dependence (AA/D) and mood disturbance are co-occurring conditions among patients who have had a traumatic brain injury (TBI). However, the relationship between these disorders has not been extensively studied.

OBJECTIVE

To examine the relationship of AA/D and post-TBI mood disorders and the effect of these conditions on psychosocial outcome.

DESIGN

Prospective, case-control surveillance study conducted during the first year following trauma. Settings University hospital level I trauma centers and specialized rehabilitation units. Patients One hundred fifty-eight TBI patients with closed head injury with and without a history of AA/D.

METHODS

We prospectively compared psychiatric, neuropsychological, and psychosocial outcomes among the patients, who were evaluated at baseline and at 3, 6, and 12 months after trauma. Psychiatric diagnosis was made using a structured clinical interview and DSM-IV criteria. Neuropsychological testing results and quantitative magnetic resonance images were obtained at the 3-month follow-up.

RESULTS

A history of AA/D was significantly more frequent among patients who developed mood disorders during the first year following TBI. There was also a significantly higher frequency of mood disorders among patients with alcohol abuse relapse. Patients with a history of AA/D had significantly reduced frontal gray matter volumes than did patients without a history of alcohol abuse. In addition, patients who resumed alcohol abuse had decreased medial frontal gray matter volumes and impaired performance in executive tasks. Both AA/D and mood disorders following TBI were associated with a poor vocational outcome.

CONCLUSIONS

Previous alcohol abuse increases the risk of developing mood disorders after TBI, and emotional disturbance, in turn, increases the risk of alcohol abuse relapse. Alcohol's neurotoxic effects and TBI likely interact to produce greater disruption of the neural circuits that modulate reward, mood, and executive function. Patients with a history of AA/D who also developed mood disorders following TBI had major difficulties resuming a productive life.

Authors+Show Affiliations

Department of Psychiatry, The University of Iowa, Iowa City, USA. ricardo-jorge@uiowa.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15997015

Citation

Jorge, Ricardo E., et al. "Alcohol Misuse and Mood Disorders Following Traumatic Brain Injury." Archives of General Psychiatry, vol. 62, no. 7, 2005, pp. 742-9.
Jorge RE, Starkstein SE, Arndt S, et al. Alcohol misuse and mood disorders following traumatic brain injury. Arch Gen Psychiatry. 2005;62(7):742-9.
Jorge, R. E., Starkstein, S. E., Arndt, S., Moser, D., Crespo-Facorro, B., & Robinson, R. G. (2005). Alcohol misuse and mood disorders following traumatic brain injury. Archives of General Psychiatry, 62(7), 742-9.
Jorge RE, et al. Alcohol Misuse and Mood Disorders Following Traumatic Brain Injury. Arch Gen Psychiatry. 2005;62(7):742-9. PubMed PMID: 15997015.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alcohol misuse and mood disorders following traumatic brain injury. AU - Jorge,Ricardo E, AU - Starkstein,Sergio E, AU - Arndt,Stephan, AU - Moser,David, AU - Crespo-Facorro,Benedicto, AU - Robinson,Robert G, PY - 2005/7/6/pubmed PY - 2005/7/15/medline PY - 2005/7/6/entrez SP - 742 EP - 9 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 62 IS - 7 N2 - CONTEXT: Alcohol abuse and/or dependence (AA/D) and mood disturbance are co-occurring conditions among patients who have had a traumatic brain injury (TBI). However, the relationship between these disorders has not been extensively studied. OBJECTIVE: To examine the relationship of AA/D and post-TBI mood disorders and the effect of these conditions on psychosocial outcome. DESIGN: Prospective, case-control surveillance study conducted during the first year following trauma. Settings University hospital level I trauma centers and specialized rehabilitation units. Patients One hundred fifty-eight TBI patients with closed head injury with and without a history of AA/D. METHODS: We prospectively compared psychiatric, neuropsychological, and psychosocial outcomes among the patients, who were evaluated at baseline and at 3, 6, and 12 months after trauma. Psychiatric diagnosis was made using a structured clinical interview and DSM-IV criteria. Neuropsychological testing results and quantitative magnetic resonance images were obtained at the 3-month follow-up. RESULTS: A history of AA/D was significantly more frequent among patients who developed mood disorders during the first year following TBI. There was also a significantly higher frequency of mood disorders among patients with alcohol abuse relapse. Patients with a history of AA/D had significantly reduced frontal gray matter volumes than did patients without a history of alcohol abuse. In addition, patients who resumed alcohol abuse had decreased medial frontal gray matter volumes and impaired performance in executive tasks. Both AA/D and mood disorders following TBI were associated with a poor vocational outcome. CONCLUSIONS: Previous alcohol abuse increases the risk of developing mood disorders after TBI, and emotional disturbance, in turn, increases the risk of alcohol abuse relapse. Alcohol's neurotoxic effects and TBI likely interact to produce greater disruption of the neural circuits that modulate reward, mood, and executive function. Patients with a history of AA/D who also developed mood disorders following TBI had major difficulties resuming a productive life. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/15997015/Alcohol_misuse_and_mood_disorders_following_traumatic_brain_injury_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archpsyc.62.7.742 DB - PRIME DP - Unbound Medicine ER -