Abstract

FRIAS IBANEZ, Álvaro; PALMA SEVILLANO, Carolina  and  FARRIOLS HERNANDO, Nuria. Traumatic brain injury in patients with psychotic syndrome: etiopathogenesis and nosological status. Rev. Asoc. Esp. Neuropsiq. [online]. 2015, vol.35, n.128, pp.837-842. ISSN 2340-2733.  https://dx.doi.org/10.4321/S0211-57352015000400011.

Introduction: One of the most controversial nosological issues in neuropsychiatry deals with the differential diagnosis between acquired and idiopathic psychosis (schizophrenia) in patients who have previously undergone a traumatic brain injury (TBI). Case report: A 15 year-old man, without personal or family psychiatric history, developed a chronic syndrome characterized by positive psychotic symptoms 5 months after suffering a TBI with loss of consciousness. The syndrome was refractory to all psychopharmacological treatments prescribed. There was no brain alteration detected through structural imaging. Discussion: TBI may play a role either as primary etiopathogenic agent (psychosis due to TBI) or as triggering factor (schizophrenia) in the development of psychotic symptoms. Fewer negative symptoms as well as lower genetic vulnerability contribute to differentiate the former group from the latter one. Usually, neither the latency period between TBI-psychosis onset nor the neurocognitive and neurobiological correlates allow to clarify the nosological status. Further controlled clinical trials are needed to assess the efficacy of antipsychotics in those subjects with psychosis due to TBI.

Keywords : Schizophrenia; differential diagnosis; nosology; psychosis; treatment; traumatic brain injury.

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