Higher-order brain dysfunction (HBD) is an administrative term which describes a clinical condition characterized by neurocognitive disorders including memory disturbance, attention deficit, executive function disorder, and social behavior disorder to an extent that interferes with one's daily life after traumatic brain injury or stroke. Patients with HBD are considered to suffer more disadvantages than those with physical disability because it often damages personal relationships at school or in the workplace. However, the department that mainly provides medical care for patients with HBD has not been clarifeid. Many HBD patients often develop depression due to adjustment disorder and some present with such severe agitation and impulsiveness that they need to hospitalized on a psychiatric ward. For HBD patients, psychiatric care can offer a diversity of intervention programs such as day-care services provided by occupational therapists and cognitive behavioral therapy for aggression provided by clinical psychologists. In addition, psychiatric care receives preferential remuneration for medical services in order to care for HBD patients over a long period. For these reasons, the authors believe that psychiatrists are the best suited to manage patients with HBD.
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