Alcohol and drug use disorders in patients with traumatic brain injury: Neurobehavioral consequences and caregiver burden

Aims. To describe the prevalence of alcohol and drugs use in patients with traumatic brain injury (TBI), and to assess their relationship with neuropsychiatric disorders, functioning and caregiver burden. Patients and methods. 156 patients with a history of moderate and severe TBI were evaluated. The use of alcohol and drugs was determined. The Neuropsychiatric Inventory (NPI) and the Zarit questionnaire were applied to caregivers. The patients functioning were assessed with the Disability Rating Scale (DRS) and Glasgow Outcome Scale Extended (GOSE). Results. 36 patients (23%) were regular users of alcohol and other drugs before the TBI. Neuropsychiatric disorders were more frequent and severe in this group, especially irritability and agitation-aggressiveness. Their caregivers perceived a higher burden. After TBI, 16 patients (44.4%) relapsed in alcohol-drugs consumption. Having a higher age and living with a partner were associated with higher rates of abstinence. Conclusion. The history of alcohol and drugs abuse is common in patients with TBI and it is a risk factor for development of behavioral disorders. More active interventions are needed aimed to detect these cases and work for prevention of relapse after trauma. © 2013 Revista de Neurología.