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Risk Factors and Predictors of Posttraumatic Psychosis Among Individuals With TBI

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Accumulated evidence suggests that injuries to the left hemisphere and to the temporal lobes may be most closely associated with risk of posttraumatic psychosis (Davison and Bagley 1969). Hillbom (1960) found that 40% of individuals with posttraumatic psychosis had temporal lobe injuries, which was a higher proportion than in those with nonpsychotic psychiatric disturbance. In a case-control study that compared brain-injured patients with and without subsequent schizophrenia-like psychoses (SLP), the SLP group had more evidence from neuroimaging of brain damage, especially in the left temporal and parietal regions (Sachdev et al. 2001). In an interesting study that evaluated electroencephalogram (EEG) abnormalities over 2 years in a cohort of 100 psychotic patients on a head injury hospital ward, posttraumatic psychosis was found in the majority of cases to be associated with EEG foci in the temporal lobes bilaterally (Koufen and Hagel 1987).

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