Mixed Subgroup of CHIT

Finally, there is a subgroup of PCCHITs with more classical postconcussive complaints representing the interactive and synergistic effects of physiologic, cognitive and psychologic changes. This sub group probably represents the greatest percentage of CHIT patients and the group most often encountered in general clinical practice. These patients may have focal residual features as well. We call them MCHITs or Mixed CHIT Syndrom$

This neuropsychiatric classification system provides a practical, clinical based approach for beginning the evaluation process. An understanding of the differentiating features of CHITs can give the health care provider more specific direction when beginning evaluation. The predominant features of MCHITs presented during diagnostic interviewing can be classified and differentiated into more specific sub categories, which can be used to determine the specificity of the neuropsychiatric evaluation.

Most patients with primary psychiatric illness have some seeds of previous psychiatric symptoms in their histories. When the patient presents with a good premorbid social history, a good work history, and a warm and supportive family and changes in behavior particularly abrupt changes in personality, mood, or ability to function, occur after CHIT, the CHIT must be considered a prime etiologic candidate. Similarly, the patient who presents with rapid fluctuations in mental status or rapid variable motor behavior frequently suggests something other than the typical psychiatric disorders - it is unusual for schizophrenics to be hallucinating and delusional in the morning and clear in the afternoon (Neppe , Tucker, 1989).