Frénisy Marie-Claude, Bénony Hervé, Chahraoui Khadija, Minot Delphine, d'Athis Philippe, Pinoit Jean-Michel, Freysz Marc
Surgical and Traumatologic Intensive Care Unit of Dijon University Hospital and Laboratory of Clinical and Social Psychology (LPCS), University of Burgundy, France.
J Trauma. 2006 May;60(5):1018-26. doi: 10.1097/01.ta.0000215977.00034.c2.
The study aims to describe the neurobehavioral and psychopathological disorders in road crash victims with cerebral lesions compared with multiple trauma sufferers with no brain damage.
This study compares the neuropsychological and psychopathological developments of two groups of road crash victims (25 severe brain injuries (SBI) and 25 multiple traumas (MULT)) on the basis of the Neurobehavioral Scale, the SCL 90-R and the State/Trait Anxiety Scale.
On the basis of the Neurobehavioral Scale, it was clear that the SBI patients suffered from significantly more disorders of type factor 1 (self-appraisal and flexible thinking), factor II (withdrawal), factor III (mood swings, irritability, disinhibition, excitement), factor IV (attention, slower motor responses, and mental fatigue), factor V (articulatory problems, problems of oral expression, and oral comprehension) and nonfactored disorders (exaggerated somatic concerns). On the SCL 90-R scale, we observed a higher level of obsessive symptoms in the SBI patients, whereas there was no significant difference between the two groups on the State/Trait Anxiety Scale. Unexpected results indicated that the multiple trauma patients suffered from memory troubles (60%), concept disorganization (32%), loss of initiative (36%), irritability (52%), unusual thought content (40%), mood swings (40%), attention difficulties (24%), suspiciousness (48%), and feelings of guilt (36%).
Even though multiple trauma sufferers do not receive a psychologic assessment of their cerebral functioning, and do not benefit from any rehabilitation, they exhibit neurobehavioral and psychopathological disorders which need to be taken into account when designing rehabilitation programs. This study points toward new therapeutic methods for the treatment of multiple trauma sufferers.
本研究旨在描述与无脑损伤的多发性创伤患者相比，脑损伤的道路交通事故受害者的神经行为和精神病理障碍。
本研究基于神经行为量表、症状自评量表90项修订版（SCL 90-R）和状态/特质焦虑量表，比较两组道路交通事故受害者（25例重度脑损伤（SBI）和25例多发性创伤（MULT））的神经心理学和精神病理学发展情况。
根据神经行为量表，很明显SBI患者在以下方面遭受的障碍明显更多：因素I型（自我评价和灵活思维）、因素II型（退缩）、因素III型（情绪波动、易怒、去抑制、兴奋）、因素IV型（注意力、运动反应迟缓及精神疲劳）、因素V型（发音问题、口语表达问题及口语理解问题）以及非因素性障碍（过度的躯体关注）。在SCL 90-R量表上，我们观察到SBI患者的强迫症状水平更高，而在状态/特质焦虑量表上两组之间没有显著差异。意外的结果表明，多发性创伤患者存在记忆障碍（60%）、概念紊乱（32%）、主动性丧失（36%）、易怒（52%）、异常思维内容（40%）、情绪波动（40%）、注意力困难（24%）、猜疑（48%）以及内疚感（36%）。
尽管多发性创伤患者没有接受脑功能的心理评估，也没有从任何康复治疗中受益，但他们表现出神经行为和精神病理障碍，在设计康复计划时需要考虑这些障碍。本研究为治疗多发性创伤患者指出了新的治疗方法。
