Assessing Prevalence of TBI in a Community Setting

Abstract

Background: Traumatic brain injury (TBI) is often under-reported and thus under-recognized by clinicians. Reports of TBI prevalence have been widely variable based on the methods of data collection and definition of TBI. This study investigates the prevalence of TBI using the Ohio State University TBI Identification Method (OSU TBI-ID), a reliable and valid structured interview designed to elicit lifetime history of TBI. We also assessed relationships between TBI and psychiatric illnesses. Identifying prevalence and effects of TBI on mental health is critical to providing personalized, higher-quality care for psychiatric patients in community settings. 

Methods: Patients receiving mental health care at the IUSM Psychiatry Residency Clinic in Vincennes, Indiana were asked to participate in a research study assessing history of head or neck injuries. Patients attended their regularly scheduled appointments with resident physicians, and 2–5-minute TBI screenings were conducted during or immediately after their appointment. Following the interview, patient charts were reviewed for documentation of prior TBI and all current psychiatric diagnoses.  

Results: Prevalence of TBI was reported at 62.3% among patients receiving psychiatric care. 87 total TBI events were recorded, including repetitive TBI events, after 77 patient interviews. The most common cause of acute TBI was vehicular accident. The most common cause of repetitive TBI was sports injury. Of the 87 TBIs, only 5 TBI events were recorded in patient charts. History of TBI was more likely in patients with PTSD as well as substance use disorders, and this was especially evident in patients with repetitive TBI.  

Conclusion and Potential Impact: This study shows that TBI is quite common among psychiatric patients and is vastly under-reported in patient charts. Increasing clinician awareness of TBI history in their patients is critical to providing high-quality care, and the OSU TBI-ID provides an efficient way to screen patients for TBI.