A case of late‐onset psychosis secondary to traumatic brain injury difficult to differentiate from delirium

TL;DR

This paper presents a case of late-onset psychosis caused by a traumatic brain injury that was hard to distinguish from delirium.

Contribution

The novelty lies in highlighting the delayed onset and delirium-like presentation of psychosis due to TBI.

Findings

Psychotic symptoms emerged nearly 20 years after the initial TBI.

Symptoms were successfully managed with risperidone.

The case posed challenges for differential diagnosis due to its delirium-like nature.

Abstract

Traumatic brain injury (TBI) is a brain injury caused by external forces and has a prevalence of 432 cases (95% uncertainty interval [UI]: 413–452) per 100,000 people in Japan. Previous studies have indicated that TBI is associated with numerous psychiatric disorders, including psychosis.

A 70‐year‐old male with a history of diabetes, bipolar disorder, and TBI sustained at the age of 51 years presented with late‐onset psychotic symptoms. This case highlights the delirium‐like fluctuating nature of psychotic symptoms and their successful management with risperidone.

Late‐onset psychotic disorders due to TBI can emerge long after initial injury and require careful and continuous monitoring.

Traumatic brain injury (TBI) causes psychotic disorders to occur in a delayed‐onset form in certain cases. In this report, we present a case of psychotic disorders due to TBI with a sudden delirium‐like onset nearly 20 years after the traumatic injury, posing significant challenges for differential diagnosis.

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