W06 - The Mental Health Professional’s Critical Role in the Understanding and Treatment of Concussion and Moderate to Severe Traumatic Brain Injuries
Friday, 23 October
11:15 – 12:45 (1.5 hrs)
Joseph Tham*, MD; Andrew Howard, MD
Supported by the Neuropsychiatry Section
At the end of this session, participants will be able to: 1) Be familiar with the mechanisms, pathophysiology, and anatomical effects of brain injury and persistent symptoms thereafter; 2) Enhance their skills in and understanding of the assessment and management of common neuropsychiatric sequelae of brain injury; and 3) Appreciate a greater number of options around care of patients with mild to severe traumatic brain injuries.
Highly prevalent in the adult and pediatric population, traumatic brain injuries extract a significant cost in lost potential and quality of life to patients and loved ones. In Canada, traumatic brain injury precipitates astounding financial losses estimated to be approximately $3 billion annually throughout the economy with devastating impacts on health care budgets.
Traumatic brain injury encompasses a broad spectrum of severity depending on pathophysiology, location, and extent. As a result, the challenges facing patients and clinicians can range from physical limitations, cognitive and psychiatric symptoms, to behavioural challenges requiring specialized care within mental health systems.
In this workshop, we will survey the spectrum of traumatic brain injury from mild (mTBI or concussion), including challenges in misdiagnosis in both the clinical and medicolegal contexts and recommendations for resolving persistent symptoms following concussion, to cases of severe injury resulting in complex needs including inpatient care. We will explore current understanding and recommendations in management of symptoms such as sleep changes, pain, emotional instability, and thought disorders. We will explore domains of neuropsychological change including cognitive dysfunction.
Finally, we will discuss the continuum of care in the Neuropsychiatry Program in British Columbia - how we have managed the needs, challenges and controversies of the adult traumatic brain injury population. We will emphasize the critical role of the mental health professional in instituting early interventions and disseminating the correct diagnosis and advising appropriate treatment in order to optimize the quality of life for individuals needlessly suffering following their injuries.
Luaute J, Plantier D, et al. Care management of the agitation or aggressiveness crisis in patients with TBI. Systematic review of the literature and practice recommendations. Ann Phys Rehabil Med. 2016:56(1):58-67.
Koponen S, Taiminen T, Portin R, Himanen L, Isoniemi H, Heinonen H, Hinkka S, Tenovuo O. Axis I and II psychiatric disorders after traumatic brain injury: a 30-year follow-up study. Am J Psychiatry. 2002:159(8):1315-21.