Research Reports - Pathological laughter and crying and psychiatric comorbidity after traumatic brain injury

J Neuropsychiatry Clin Neurosci. 2015 Aug 10:appineuropsych15030045. [Epub ahead of print]

Roy D(1), McCann U(1), Han D(1), Rao V(1).

There are limited data regarding the incidence of pathological laughter and
crying (PLC) after traumatic brain injury (TBI). This study aimed to identify the
occurrence of PLC in the first year after TBI and to determine whether there is a
relationship between PLC and other clinical features or demographics. Subjects
who sustained a first-time TBI were recruited from acute trauma units and were
assessed at 3, 6, and 12 months after TBI. Rates of PLC at 3, 6, and 12 months
after TBI were 21.4%, 17.5%, and 15.5%, respectively. Patients with PLC had
higher percentages of psychiatric diagnoses, including personality changes,
depressive disorders, and mood disorders secondary to a general medical
condition, as well as higher rates of posttraumatic stress disorder. Univariate
logistic and linear regression analyses indicated a significant association
between PLC and scores on the Clinical Anxiety Scale 3 months after TBI and on
the Hamilton Depression Rating Scale 12 months after TBI. Individuals who have
PLC during the first year after TBI are more likely to have any psychiatric
diagnosis as well as higher rates of mood and anxiety symptoms. In addition, PLC
in the early TBI period may serve as a predictor of depression and anxiety
symptoms at 12 months after TBI.

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