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Tijdschrift voor Psychiatrie 55 (2013) 9, 665 - 675

New research

Patients with brain injury in a psychiatric setting; assessment of health care needs and received care

C.M. van Heugten, E.P.J. Janssen, A.J.M. Visscher, G. Wolters Gregório, S. Smeets, R.M.W.J. Berkers, R.W.M. Ponds

Summary

background In some Dutch mental health care organisations specific neuropsychiatric departments have been developed for patients with brain injury.
aim To identify the characteristics of patients with brain injury who form a specific population in mental health care and to determine whether such patients require either specialised care or a special type of care.
method A cross-sectional analysis of typical brain injury inpatients was performed. We noted the age and gender of these patients and recorded any previous periods of inpatient care. We listed patients’ impairments, the diagnoses they had been given and the treatment they had received. This inventory formed the basis of our conclusions.
results The typical clinical patient with brain injury in this setting was a male of 51 years or older, most probably affected by a stroke or traumatic brain injury, admitted for a period of 6 months, many years after the incident. He was mostly referred from home or hospital by a physician and was expected to return home again. A combination of cognitive and psychiatric impairments was often found. Physically the patient had no or only mild disabilities, but societal participation was low and many cognitive-affective disorders were seen. Treatment was relatively infrequent and mostly directed at daily activities. The most frequent diagnosis was ‘cognitive deficits not otherwise specified’. Irritability, agitation, apathy and depression were frequent symptoms.
conclusion This inventory suggests that brain injury patients in a mental health care setting need special care which is not available in other health care settings.

keywords brain injury, neuropsychiatry, treatment