Hull A M, Lowe T, Devlin M, Finlay P, Koppel D, Stewart A M
Aberdeen Centre for Trauma Research, Bennachie Building, Royal Cornhill Hospital, Scotland, Aberdeen, UK.
Br J Oral Maxillofac Surg. 2003 Oct;41(5):317-22. doi: 10.1016/s0266-4356(03)00131-1.
To identify the prevalence of post-traumatic psychological symptoms after maxillofacial trauma and prognostic factors related to poor outcome.
Thirty-nine patients were assessed within 10 days of injury and 24 again 4-6 weeks later using five standardised self-report measures on each occasion and a short structured interview at the time of initial contact.
Specific post-traumatic psychological symptoms were present at initial assessment in 21 patients (54%), with 9 (41%) meeting diagnostic criteria for post-traumatic stress disorder at review 4-6 weeks later. Other psychiatric problems, such as anxiety and depression, were identified by the General Health Questionnaire and the Hospital Anxiety and Depression Scale. Characteristics associated with poorer outcome included: a previous history of psychological distress; fear of the unknown, and female sex.
These findings highlight the adverse psychological effect of maxillofacial trauma both immediately after the event and 4-6 weeks after injury. Proper assessment of injured patients must include psychological aspects and further research is needed to identify the most appropriate response.
确定颌面创伤后创伤后心理症状的患病率以及与不良预后相关的预后因素。
39名患者在受伤后10天内接受评估,4至6周后再次接受评估,每次使用五项标准化的自我报告测量方法,并在初次接触时进行简短的结构化访谈。
初次评估时,21名患者(54%)出现特定的创伤后心理症状,4至6周后复查时,9名患者(41%)符合创伤后应激障碍的诊断标准。通过一般健康问卷和医院焦虑抑郁量表识别出其他精神问题,如焦虑和抑郁。与较差预后相关的特征包括:既往有心理困扰史;对未知的恐惧以及女性性别。
这些发现凸显了颌面创伤在事件发生后即刻以及受伤后4至6周所产生的不良心理影响。对受伤患者的正确评估必须包括心理方面,并且需要进一步研究以确定最合适的应对措施。