Psychopharmacology bulletin · 2026
Traumatic Brain Injury and Delusional Disorder: A Narrative Synthesis with Psychopharmacologic Implications.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Sarangal Mridul, Sarangal Charmi
Аннотация
BACKGROUND: Traumatic brain injury (TBI) is associated with a range of neuropsychiatric sequelae, including secondary psychotic disorders. Delusional syndromes are a prominent and clinically significant manifestation, often classified as Psychotic Disorder Due to Another Medical Condition.1,2.
METHODS: This narrative synthesis reviews case series, cohort studies, retrospective analyses, and conceptual literature published between 1998 and 2025, focusing on epidemiology, clinical features, pathophysiology, diagnosis, and psychopharmacologic management of post-TBI delusional syndromes.
RESULTS: Delusions-commonly persecutory or misidentification types-frequently emerge after a latency of months to years and are more prevalent than schizophrenia-like presentations.1,2,6 Risk factors include moderate-to-severe injury, frontal or temporal lesions (particularly right-sided), post-traumatic epilepsy, and genetic vulnerability.3-6 Compared to primary psychotic disorders, negative symptoms are typically less prominent, though cognitive impairment is nearly universal.6,7,12 Low-dose atypical antipsychotics demonstrate favorable response rates, but tolerability concerns-including sedation, extrapyramidal symptoms, and seizure risk-necessitate cautious use.8,9 Adjunctive anticonvulsants may be beneficial, particularly in patients with comorbid epilepsy.10,15.
CONCLUSIONS: Post-TBI delusional syndromes highlight the role of structural brain injury in the development of psychosis. Careful diagnostic evaluation and individualized, low-dose psychopharmacologic strategies are essential. Further research is needed to guide evidence-based treatment in this population.
METHODS: This narrative synthesis reviews case series, cohort studies, retrospective analyses, and conceptual literature published between 1998 and 2025, focusing on epidemiology, clinical features, pathophysiology, diagnosis, and psychopharmacologic management of post-TBI delusional syndromes.
RESULTS: Delusions-commonly persecutory or misidentification types-frequently emerge after a latency of months to years and are more prevalent than schizophrenia-like presentations.1,2,6 Risk factors include moderate-to-severe injury, frontal or temporal lesions (particularly right-sided), post-traumatic epilepsy, and genetic vulnerability.3-6 Compared to primary psychotic disorders, negative symptoms are typically less prominent, though cognitive impairment is nearly universal.6,7,12 Low-dose atypical antipsychotics demonstrate favorable response rates, but tolerability concerns-including sedation, extrapyramidal symptoms, and seizure risk-necessitate cautious use.8,9 Adjunctive anticonvulsants may be beneficial, particularly in patients with comorbid epilepsy.10,15.
CONCLUSIONS: Post-TBI delusional syndromes highlight the role of structural brain injury in the development of psychosis. Careful diagnostic evaluation and individualized, low-dose psychopharmacologic strategies are essential. Further research is needed to guide evidence-based treatment in this population.