Betsi Cadwaladr University Health Board, North Wales Brain Injury Service e-mail: Rudi.Coetzer{at}wales.nhs.uk To the Editor: In addition to physical and cognitive impairment, neuropsychiatric disturbances after traumatic brain injury (TBI) are relatively common.1 Although depression and anxiety are most common,1,2 obsessive-compulsive disorder (OCD) has also been reported,1–3 albeit less frequently, and possibly representing a more transient neuropsychiatric complication of TBI.3 Diagnosing OCD in the context of TBI is complex because of overlapping symptomatology.4 Cognitive impairment, for example, of memory, can be difficult to distinguish from compulsions. Similarly, impairment of executive function, in particular, perseveration, can be mistaken for obsessions. Structured cognitive assessment may disentangle these symptoms and help clarify diagnoses in individual cases.Case Reports The first case has been reported in greater depth elsewhere2 and is presented for comparison only. A 27-year-old man presented with OCD with severe TBI, after a road-traffic collision 51/2 years earlier. He presented with clear obsessions and compulsions. His Florida Obsessive Compulsive Inventory (FOCI)5 provided further evidence of obsessions and compulsion. There was no premorbid history of psychiatric illness. A CT of the brain showed a fracture of the left parietal bone extending into the floor of the anterior fossa, a left frontal contusion,
Does Memory Impairment Exclude a Diagnosis of OCD After Traumatic Brain Injury?
Abstract
Betsi Cadwaladr University Health Board, North Wales Brain Injury Service e-mail: Rudi.Coetzer{at}wales.nhs.uk To the Editor: In addition to physical and cognitive impairment, neuropsychiatric disturbances after traumatic brain injury (TBI) are relatively common.1 Although depression and anxiety are most common,1,2 obsessive-compulsive disorder (OCD) has also been reported,1–3 albeit less frequently, and possibly representing a more transient neuropsychiatric complication of TBI.3 Diagnosing OCD in the context of TBI is complex because of overlapping symptomatology.4 Cognitive impairment, for example, of memory, can be difficult to distinguish from compulsions. Similarly, impairment of executive function, in particular, perseveration, can be mistaken for obsessions. Structured cognitive assessment may disentangle these symptoms and help clarify diagnoses in individual cases.Case Reports The first case has been reported in greater depth elsewhere2 and is presented for comparison only. A 27-year-old man presented with OCD with severe TBI, after a road-traffic collision 51/2 years earlier. He presented with clear obsessions and compulsions. His Florida Obsessive Compulsive Inventory (FOCI)5 provided further evidence of obsessions and compulsion. There was no premorbid history of psychiatric illness. A CT of the brain showed a fracture of the left parietal bone extending into the floor of the anterior fossa, a left frontal contusion,
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Does Memory Impairment Exclude a Diagnosis of OCD After Traumatic Brain Injury?
Coetzer, Rudi
Follow Journal of Neuropsychiatry & Clinical Neurosciences
, Volume 23 (3): E12
American Psychiatric Publishing, Inc (Journal) – Aug 1, 2011
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