Anxiety following mild traumatic brain injury

Purpose/Objective: The goals of the present study were (1) to document the prevalence of anxiety-related disorders and anxiety symptoms at 4, 8, and 12 months post-injury in individuals with mild traumatic brain injury (mTBI) while considering pre-injury history of anxiety disorders and (2) to verify whether the presence of anxiety in the first months following mTBI was associated with more symptoms present one year after the injury. Research Method/Design: One hundred and twenty participants hospitalized after an accident and having sustained mTBI were assessed at 4, 8, and 12 months post-accident with the Mini-International Neuropsychiatric Interview, the Hospital Anxiety and Depression Scale and questionnaires assessing fatigue, irritability, perceived stress, cognitive difficulties, depression, insomnia, and pain. Results: At 4 months, 23.8% of participants presented with at least one anxiety-related disorder compared to 15.2% at 8 months and 11.2% at 12 months. Overall, 32.5% presented with at least one anxiety disorder over the first 12 months post-mTBI. Participants with a history of anxiety (20.5%) were significantly more anxious following their accident. Individuals who were anxious 4 months after the accident presented with more symptoms in different areas 12 months post-injury compared to non-anxious individuals. Conclusions/Implications: The present results highlight that anxiety should be evaluated and managed carefully as it appears to be a key factor in the persistence of other mTBI-related symptom

Caractéristiques comportementales et attentionnelles des porteurs de l'allèle à 7 répétitions (7R) du récepteur dopaminergique D4 (DRD4) chez les enfants atteints d'un trouble déficitaire de l'attention avec hyperactivité (TDAH)

Le trouble déficitaire de l'attention avec ou sans hyperactivité (TDAH) est un trouble neurobiologique fréquent chez les enfants d'âge scolaire. L'étiologie du TDAH inclut une forte composante génétique et implique le système dopaminergique. Il y aurait une association entre le trouble et l'allele à 7 répétitions (7R) du gène du récepteur de la dopamine D4 (DRD4). Cependant, les caractéristiques cliniques du TDAH associées à ce polymorphisme sont peu étudiées dans les populations caucasiennes. Le but de cette étude est de déterminer les caractéristiques comportementales (échelle de Conners et child behavior checklist) et attentionnelles (NEPSY et CPT) associées à la présence ou l'absence de l'allèle DRD4-7R dans une population d'enfants canadiens-français atteints de TDAH (n = 137). Nos résultats montrent que les enfants atteints de TDAH et porteurs du DRD4-7R ont significativement plus de problèmes de comportement, mais à l'inverse, ils ont une meilleure attention visuelle que les non-porteurs du polymorphisme. L'identification de profils spécifiques associés à des facteurs de risque génétiques pourrait améliorer la compréhension de l'implication du système dopaminergique ainsi que dans l'étiologie du TDAH

Depression in the first year after traumatic brain injury

The aims of this study were to document the frequency of major and minor depressive episodes in the first year after traumatic brain injury (TBI), taking into account TBI severity and pre-morbid history of major depression, and to describe trajectories of depressive episodes. Participants were 227 adults who were hospitalized post-TBI (76% male; mean age = 41 years; 50% mild, 33% moderate, and 17% severe TBI). Major and minor depressive episodes were assessed with the Mini International Neuropsychiatric Interview at three time points (4, 8, and 12 months after TBI). Overall, 29% of participants had a major depressive episode in at least one of the three assessments, with fairly stable rates across assessments. Participants with mild TBI were more likely than those with moderate/severe TBI to be diagnosed with major depression, as were individuals with a positive pre-morbid history of depression compared to those without such history. In addition, 13% of participants had a minor depressive episode in at least one of the three assessments. Rates of minor depression significantly decreased from 4 to 8–12 months post-injury. Results also revealed a wide variety of trajectories of depressive episodes across assessments. Of note, 52% of major depression cases still fulfilled diagnostic criteria 4 months later, whereas 38% of minor depression cases deteriorated to major depression at the following assessment. These findings suggest that depression is highly prevalent after TBI, and monitoring of patients with subthreshold depressive symptoms is warranted in order to prevent the development of full-blown major depressive episodes