Correlation between frontal lobe injury severity caused by traumatic brain injury and mental disorders with early prognosis

doi:10.5498/wjp.v16.i6.116354

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Jun 19, 2026; 16(6): 116354
Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.116354

Table 1 Clinical characteristics of different frontal lobe injury severity groups

	Mild injury (n = 112)	Moderate injury (n = 64)	Severe injury (n = 42)	F or H or χ²	P value
Age (year)	54.13 ± 13.05	55.83 ± 11.01	57.21 ± 10.64	1.120	0.328
Sex				1.066	0.587
Male	78 (69.64)	41 (64.06)	26 (61.90)
Female	34 (30.36)	23 (35.94)	16 (38.10)
Education				0.501	0.779
≤ High school	90 (80.36)	54 (83.38)	35 (83.33)
≥ College	22 (19.64)	10 (15.62)	7 (16.67)
Smoking history	30 (26.79)	16 (25.00)	10 (23.81)	0.164	0.921
Alcohol misuse history	26 (23.21)	20 (31.25)	20 (47.62)^a	8.659	0.013
Pre-injury substance abuse	8 (7.14)	4 (6.25)	1 (2.38)	1.044	0.688
Pre-existing mental illness	13 (11.61)	6 (9.38)	5 (11.90)	0.296	0.880
Basic diseases	31 (27.68)	13 (20.31)	13 (30.95)	1.767	0.413
Cause of trauma				2.700	0.855
Traffic accident	54 (48.21)	28 (43.75)	21 (50.00)
Fall accident	28 (25.00)	15 (23.44)	8 (19.05)
Violent assaults	11 (9.82)	9 (14.06)	3 (7.14)
Other	19 (16.97)	12 (18.75)	10 (23.81)
Time from injury to first aid (hour)				1.231	0.540
< 6	89 (79.46)	48 (75.00)	30 (71.43)
≥ 6	23 (20.54)	16 (25.00)	12 (28.57)
Multiple traumatic injuries	52 (46.43)	33 (51.56)	31 (73.81)^a^,^b	9.297	0.010
Marshall CT classification				9.705	0.008
≤ IV	94 (83.93)	53 (82.81)	26 (61.90)^a^,^b
> IV	18 (16.07)	11 (17.19)	16 (38.10)
Post-traumatic surgery	43 (38.39)	29 (45.31)	32 (76.19)^a^,^b	17.701	< 0.001
Hypotension	36 (32.14)	37 (57.81)^a	32 (76.19)^a	27.115	< 0.001
Hypoxia	15 (13.39)	19 (29.69)^a	21 (50.00)^a^,^b	22.654	< 0.001
Laboratory results
APTT (second)	30.57 ± 5.11	35.25 ± 5.52^a	44.65 ± 7.51^a^,^b	105.622	< 0.001
PCT (ng/L)	1.84 (1.00, 2.93)	3.64 (1.65, 5.12)^a	9.54 (7.84, 13.96)^a^,^b	98.919	< 0.001
Cre (mmol/L)	45.68 ± 2.76	49.38 ± 3.24^a	53.62 ± 2.16^a^,^b	128.369	< 0.001
NSE (ng/mL)	16.74 (12.83, 19.47)	23.94 (15.52, 34.19)^a	31.59 (22.79, 39.84)^a^,^b	66.829	< 0.001
Admission GCS score	14.07 ± 0.81	10.16 ± 1.01^a	5.64 ± 1.71^a^,^b	955.197	< 0.001

^aP < 0.05 vs mild group.

^bP < 0.05 vs moderate group.

Continuous variables with normal distribution were expressed as means ± SD. Non-normally distributed continuous variables were presented as medians (25^th, 75^th percentiles). Categorical variables were expressed as n (%). CT: Computed tomography; APTT: Activated partial thromboplastin time; PCT: Procalcitonin; Cr: Serum creatinine; NSE: Serum neuron-specific enolase; GCS: Glasgow Coma Scale.

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Table 2 Comparison of scale scores in different severity groups

Group	HAMA	HAMD	PCL-5	MoCA	GOS
Mild	5 (3, 6)	5 (4, 7)	15 (11, 21)	26.99 ± 3.26	4.52 ± 0.76
Moderate	6 (5, 7)^a	6 (5, 8)^a	16 (12, 34)^a	24.39 ± 6.88^a	3.92 ± 0.84^a
Severe	8 (6, 25)^a^,^b	12 (6, 15)^a^,^b	28 (17, 37)^a^,^b	22.83 ± 7.13^a	3.05 ± 1.13^a^,^b
F/H	40.288	28.529	28.560	10.768	45.381
P value	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

^aP < 0.05 vs mild group.

^bP < 0.05 vs moderate group.

Continuous variables with normal distribution were expressed as means ± SD. Non-normally distributed continuous variables were presented as medians (25^th, 75^th percentiles). HAMA: Hamilton Anxiety Scale; HAMD: Hamilton Depression Rating Scale; PCL-5: Post-Traumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition; MoCA: Montreal Cognitive Assessment; GOS: Glasgow Outcome Scale.

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Table 3 Logistic regression analysis of associations between frontal lobe injury severity and mental disorders

	Model 1		Model 2		Model 3
	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value
Mild	Reference		Reference		Reference
Moderate	2.436 (1.299-4.567)	0.006	2.383 (1.260-4.509)	0.008	3.454 (1.650-7.231)	0.001
Severe	4.697 (2.138-10.319)	< 0.001	4.477 (2.012-9.930)	< 0.001	8.034 (3.017-21.390)	< 0.001
P value for trend		< 0.001		< 0.001		< 0.001

Model 1: Not adjusted for confounding factors; Model 2: Adjusted for age and gender; Model 3: Further adjusted for age, gender, education level, smoking history, alcohol misuse history, pre-injury substance abuse, pre-existing mental illness, basic diseases, trauma cause, time from injury to first aid, multiple traumatic injuries, Marshall computed tomography classification, post-traumatic surgery, hypotension, and hypoxia.

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Table 4 Logistic regression analysis of associations between frontal lobe injury severity and poor prognosis

	Model 1		Model 2		Model 3
	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value
Mild	Reference		Reference		Reference
Moderate	3.519 (1.575-7.860)	0.002	3.553 (1.560-8.091)	0.003	3.334 (1.256-8.853)	0.016
Severe	13.542 (5.708-32.127)	< 0.001	13.794 (5.663-33.597)	< 0.001	14.626 (4.600-46.504)	< 0.001
P value for trend		< 0.001		< 0.001		< 0.001

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Citation: Bai J, Duan GW, Song Q, Ma TF. Correlation between frontal lobe injury severity caused by traumatic brain injury and mental disorders with early prognosis. World J Psychiatry 2026; 16(6): 116354
URL: https://www.wjgnet.com/2220-3206/full/v16/i6/116354.htm
DOI: https://dx.doi.org/10.5498/wjp.v16.i6.116354

Bai J, Duan GW, Song Q, Ma TF. Correlation between frontal lobe injury severity caused by traumatic brain injury and mental disorders with early prognosis. World J Psychiatry 2026; 16(6): 116354 [DOI: 10.5498/wjp.v16.i6.116354]

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