Neurobehavioural symptoms one year after a head injury.

BACKGROUND Neurobehavioural symptoms are common immediately after a minor head injury but have not been studied one year after the injury. AIMS To estimate the rate and pattern of neurobehavioural symptoms one year after a head injury of varying severity. METHOD Adults who had been hospitalised after a head injury (n = 196, 164 of whom had a face-to-face interview) and showed indirect evidence of brain assault were assessed for the presence of neurobehavioural symptoms with the help of a behaviour rating scale. RESULTS About 40% had three or more symptoms. Individual symptoms varied among 3% (social disinhibition), 15% (lack of initiative) and 35% (irritability) of the cohort. Premorbid factors such as lower social class and lower educational achievement, head-injury-related factors such a low Glasgow coma score, and outcome-related factors such as the presence of a disability according to the Edinburgh Rehabilitation Status Scale and psychiatric caseness according to the Clinical Interview Schedule--Revised, significantly influenced the rate and the pattern of behavioural symptoms. The pattern of symptoms varied between age groups and according to the severity of the head injury. CONCLUSIONS A significant proportion of patients with varying degrees of severity of head injury showed behavioural symptoms after one year of head injury.