Meares Susanne, Shores E Arthur, Batchelor Jennifer, Baguley Ian J, Chapman Jennifer, Gurka Joseph, Marosszeky Jeno E
Department of Psychology, Macquarie University, New South Wales, Australia.
J Int Neuropsychol Soc. 2006 Nov;12(6):792-801. doi: 10.1017/S1355617706060978.
The relationship of psychological and cognitive factors in the development of the postconcussion syndrome (PCS) following mild uncomplicated traumatic brain injury (mTBI) has received little study. This may be because of the widely held belief that neurological factors are the cause of early PCS symptoms, whereas psychological factors are responsible for enduring symptoms. To further understand these relationships, the association between PCS and neuropsychological and psychological outcome was investigated in 122 general trauma patients, many of whom had orthopedic injuries, around 5 days following mTBI. Apart from verbal fluency, participants with a PCS did not differ in their performances on neuropsychological measures compared to those without a PCS. Individuals with a PCS reported significantly more psychological symptoms. Large effect sizes present on the psychological measures showed that the difference between participants with a PCS and without was greater on psychological than on neuropsychological measures. Analyses also revealed a relationship between opioid analgesia and depression, anxiety and stress, and opioids and reduced learning. The results suggest that psychological factors are present much earlier than has previously been considered in the development of the PCS.
轻度单纯性创伤性脑损伤（mTBI）后创伤后综合征（PCS）发展过程中心理和认知因素之间的关系鲜有研究。这可能是因为人们普遍认为神经因素是PCS早期症状的原因，而心理因素则导致症状持续存在。为了进一步了解这些关系，在122名一般创伤患者中调查了PCS与神经心理学和心理结果之间的关联，其中许多人有骨科损伤，时间约在mTBI后5天。除了言语流畅性外，与没有PCS的参与者相比，有PCS的参与者在神经心理学测量中的表现没有差异。有PCS的个体报告的心理症状明显更多。心理测量中呈现的大效应量表明，有PCS和没有PCS的参与者之间在心理测量上的差异大于在神经心理学测量上的差异。分析还揭示了阿片类镇痛与抑郁、焦虑和压力之间的关系，以及阿片类药物与学习能力下降之间的关系。结果表明，心理因素在PCS发展过程中出现的时间比以前认为的要早得多。
