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Tijdschrift voor Psychiatrie 61 (2019) 12, 862 - 878

Review article

Prevalence and manifestations of aggression in adult patients with acquired brain injury: a review

C.G.J.G Pouwels, G. Wolters Grégorio, P.J.J. Spauwen, B.A.A. Bus, I. Winkens, R.W.H.M. Ponds

background Aggression after acquired brain injury has a major impact on daily functioning for the patient, their family, and caregivers.
aim To present the prevalence and manifestations of aggression in patients with different types of brain injury.
method Systematic search of the literature in PubMed, Psycinfo and Embase.
results Fourty-one studies were included in which 15 different outcome measures for aggression were used. The prevalence of agitation ranged between 4.0%-93.9% (median 35.8%), of aggression between 3.7%-88.0% (median 35.3%) and of hostility between 4.0%-45.7% (median 9.1%). Prevalence rates were highest in patients with traumatic brain injury. Verbal aggression occurred more frequently (median 33.0%, 14.0%-70.0%) than physical aggression (median 11.5%, 1.5%-33.8%), but manifestations of aggression were only examined in ten studies.
conclusion Aggression is a common behavioral problem after brain injury. The prevalence varies and depends on the type of brain injury, the specific target behavior and the outcome measure. It is recommended to reach consensus on definitions and outcome measures.

keywords agitation, aggression, brain injury, prevalence, review