Psychopathologie et traumatisme craniocérébral sévère de l'adulte

Behavioural disorders are the main factor of handicap after severe Traumatic Brain Injury (TBI). They reflect 3 interfering etiological dimensions: neuropsychological (or lesional), psychopathological, social or environmental. The evaluation takes into account the complaints of the patient and, moreover, the relative's opinion, the pre and post-traumatic history, a semi-structured interview, the observation, the way of life and the handicap. The main disorders are: loss of initiative, loss of emotional control, somatic complaints, depression and anxiety, family consequences and the hard process of handicap acceptance and identity reconstruction. The pharmacological treatment is poorly assessed. In addition to individual and family oriented psychotherapies, care is based on holistic and multidisciplinary “resocialisation” programs.