Citation

Bourseau T, Saout V, Ali P, Pouliquen-Loriferne U, Allain P, Dinomais M. J. Head Trauma Rehabil. 2019; 34(4): E51-E60.

Affiliation

Département de Médecine Physique et de Réadaptation, CHU d'Angers, Université d'Angers (Drs Bourseau, Ali, and Dinomais), Centre de Réadaptation Spécialisée, Les Capucins (Drs Bourseau, Ali, and Dinomais), Laboratoire de Psychologie des Pays de la Loire (LLPL EA 4638), Université d'Angers (Dr Allain), and Mutualité Française Anjou Mayenne, Arceau Anjou (Dr Saoût), Angers, France; and Centre de Médecine Physique et de Réadaptation, Le Confluent, Croix Rouge Française, Nantes, France (Dr Pouliquen-Loriferne).

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000452

PMID

30499933

Abstract

OBJECTIVE: To give a cross-sectional overview of ongoing management of behavioral disorders following traumatic brain injury (TBI) in a region of France, to compare this with recent recommendations from the French Society of Physical Medicine and Rehabilitation (SOFMER), and to evaluate associations between treatments and participant characteristics. SETTING: Outpatients referred to medical or community-based facilities in a region of France. PARTICIPANTS: One hundred twenty-nine adults with moderate to severe TBI, in the postacute period (over 3 months postinjury).

DESIGN: Cross-sectional cohort study. MAIN MEASURES: Sociodemographic data, ongoing interventions including psychotherapy and medication, behavioral disorders assessed by the Behavioral Dysexecutive Syndrome Inventory (BDSI).

RESULTS: Thirty-three percent of participants received ongoing psychotherapy and 43% were on medication. The most prescribed medications were antidepressants (21%), neuroleptics (18%), anxiolytics (16%), and mood stabilizers (14%). Eighty-five participants (71%) presented a current Behavioral Dysexecutive Syndrome (BDS) according to the BDSI. These participants more frequently received treatment (P =.004), psychotherapy (P =.048), medications (often 2 or more) (P =.007), and particularly antiepileptic mood stabilizers (P =.037) compared with those without BDS.

CONCLUSION: Although recommended as first-line treatment, few participants with BDS received psychotherapy. Medications were overused, especially neuroleptics in view of their potential adverse effects. In contrast, recommended medications, such as mood stabilizers and β-blockers, did not appear to be highly prescribed whatever the evolution. Compliance with recommendations seemed insufficient.

Language: en