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

Kato T, Tsujii T, Kida H, Mochizuki D, Nikkuni S, Sakuma K

PCN reports : psychiatry and clinical neurosciences, 2025

100,000 participants

Abstract

Background: 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.

Case presentation: 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.

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

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