Schizophrenia and Traumatic Brain Injury

							For victims of a traumatic brain injury (TBI) and their families, side effects such as
bipolar disorder and memory loss are tragic, but well known and well understood. But
in the last decades, scientists have begun to study another serious side effect of brain
damage that may go undetected: schizophrenia.

What is Schizophrenia?

Schizophrenia (Greek for "shattered mind") is a psychotic disorder that affects
behavior, mood and thinking. The term was originally coined as "the schizophrenias"
because of the wide variety of symptoms characterizing the condition. The most
widely known symptom, auditory hallucination ("hearing voices"), may not even be
present in all who have a diagnosis of schizophrenia. Psychologists break symptoms
of schizophrenia into three categories:

. Positive symptoms are behaviors that are not present in normal individuals. They
include auditory hallucinations, delusions and thought disorder, or disorganized
thinking.

. Negative symptoms are symptoms showing loss of normal abilities. They include
loss of ability to show or feel emotion, lack of motivation and trouble with speaking.

. Neurocognitive defects are problems with brain function in areas such as memory,
problem-solving, attention and social functioning.

Schizophrenia Related to Brain Injury in Patients

Scientists have established that psychiatric conditions such as bipolar and anxiety
disorders are more common in patients who have suffered from traumatic brain
injuries. We also know that patients with schizophrenia have a high incidence of past
brain damage, regardless of whether they have other strong predictors for
schizophrenia, such as a family history of the disorder or maleness. But it is only
since the early 1990s that researchers have begun to explore in depth that connection
between brain damage caused by traumatic brain injury and schizophrenia.

Schizophrenia and Brain Injury: Recent Studies

. Among the findings of those studies:

. TBI-associated schizophrenia is true schizophrenia, not another disorder with similar
symptoms, according to a 2001 study by Columbia University. The scientists observed
that traumatic brain injury was associated with a greater risk of schizophrenia,
suggesting that one condition increases a person chances of developing the other.

. Another study in the same year at the University of New South Wales in Australia
discovered that TBI patients with schizophrenia-like psychosis had more widespread
brain damage and cognitive impairment than TBI patients without psychosis. It also
suggested that a family history of schizophrenia and the severity of the brain damage
sustained during TBI increased the risk of schizophrenia.

. Scientists at the Hawaii State Hospital found in 2002 that it took an average of four
to five years after a traumatic brain injury for psychosis to manifest, with most cases
arriving within two years. The scientists in that study proposed that damage to frontal
and temporal areas of the brain, and to the system that regulates dopamine, can cause
psychosis.

While the complex nature of schizophrenia makes its cause unclear, as the last study
suggests, there is evidence to believe that brain injury directly causes schizophrenia,
by damaging the areas of the brain that control higher functions. There is also
evidence that a traumatic brain injury may cause psychosis indirectly. Scientists
believe that schizophrenia is caused by a combination of genetic susceptibility to the
disease and an emotionally or physically traumatic experience that triggers this
susceptibility. Some studies exploring the two conditions suggest that traumatic brain
injury and its complications may act as such a trigger.

Many physicians know a traumatic brain injur may cause neurocognitive disorders
such as trouble with speech, and psychiatric problems like bipolar disorder, but not all
are aware of the growing evidence linking schizophrenia with brain damage. TBI
patients and their families should be sure to include a qualified psychiatrist in their
plans for brain damage treatment. In addition, brain injury patients and their families
should consult an experienced brain injury attorney as they seek to recover costs for
expenses such as lost wages, current medical costs and future medical care.