León-Carrión José
Human Neuropsychology Laboratory, Dept. of Experimental Psychology, University of Seville, San Francisco Javier s/n, 41005 Seville, Spain.
NeuroRehabilitation. 2002;17(2):115-22.
This paper questions the DSM IV TR criteria for Dementia Due to Head Trauma (DDHT). We studied 20 consecutive traumatic brain injury (TBI) patients and checked them for this criteria. We found the diagnosis criteria to be oversensitive and lacking in specificity, consequently raising the possibility for all subjects who have sustained severe TBI to be diagnosed with dementia. A careful analysis of data and literature showed that nearly half of these patients were able to return to work after undergoing an intensive and holistic rehabilitation program, indicating a reversal of the "dementia". Severe head injury produces a set of multiple cognitive deficits that shouldn't be considered dementia. The term "Severe Neurocognitive Disorder" is suggested for use instead of DDHT for the cognitive deterioration of severe TBI patients.
本文对《精神疾病诊断与统计手册》第四版修订版(DSM IV TR)中因头部创伤所致痴呆(DDHT)的诊断标准提出质疑。我们研究了连续20例创伤性脑损伤(TBI)患者,并依据该标准对他们进行检查。我们发现该诊断标准过于敏感且缺乏特异性,从而增加了所有遭受严重TBI的受试者被诊断为痴呆的可能性。对数据和文献的仔细分析表明,近一半的这些患者在接受强化和全面的康复计划后能够重返工作岗位,这表明“痴呆”出现了逆转。严重头部损伤会产生一系列多种认知缺陷,不应将其视为痴呆。建议使用“严重神经认知障碍”这一术语来取代DDHT,以描述严重TBI患者的认知衰退。