创伤性脑损伤的神经精神后果：两个年龄组的比较

Neuropsychiatric consequences of traumatic brain injury: a comparison between two age groups.

作者信息

Deb Shoumitro, Burns James

机构信息

Division of Neuropsychiatry, Queen Elizabeth Psychiatric Hospital, University of Birmingham, Birmingham, UK.

出版信息

Brain Inj. 2007 Mar;21(3):301-7. doi: 10.1080/02699050701253137.

DOI:10.1080/02699050701253137

PMID:17453758

Abstract

BACKGROUND

Neurobehavioural symptoms and certain psychiatric disorders are common after a traumatic brain injury (TBI). Relatively few studies have investigated the effect of age upon these outcomes.

AIM

Our aim was to compare the rates of neurobehavioural symptoms and psychiatric disorders between 18-65 year old and over 65 year old patients with TBI.

METHOD

120 adults aged 18 to 65 years and 45 adults over 65 years of age who were admitted to a hospital following a TBI were assessed for neurobehavioural symptoms and psychiatric disorders one year after the injury.

RESULTS

Our estimate suggested that a higher proportion of 18-65 year old patients (32%) had ICD-10 psychiatric disorders according to the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) interview compared with patients over 65 years of age (16%). Similarly, the ICD-10 depressive disorder was more common among the younger patients (16%) than the older group of patients (11%). None of these differences were statistically significant. However, a multiple regression analysis revealed that among other risk factors, a younger age was significantly associated with the presence of a psychiatric disorder. Also, a significantly higher rate of psychiatric caseness was detected among the younger age group using screening instruments such as the General Health Questionniare-28 (GHQ-28) (p < 0.01) and the Clinical Interview Schedule-Revised (CIS-R) (p < 0.01). The rates of individual neurobehavioural symptoms varied significantly between the two age groups. The most prevalent symptoms in 18-65 year olds were irritability (37%) and sleep problems (37%). In the older group of patients the most prevalent symptoms were poor memory (40%), dependence (38%) and slowness in thinking (33%).

CONCLUSION

18-65 year old patients are likely to be at a greater risk of psychiatric morbidity following TBI than over 65 year olds whereas neurobehavioural symptoms are prevalent in both age groups.

摘要

背景

创伤性脑损伤（TBI）后神经行为症状和某些精神障碍很常见。相对较少的研究调查了年龄对这些结果的影响。

目的

我们的目的是比较18至65岁和65岁以上TBI患者的神经行为症状和精神障碍发生率。

方法

120名18至65岁的成年人和45名65岁以上的成年人在TBI后入院，在受伤一年后对其神经行为症状和精神障碍进行评估。

结果

我们的估计表明，根据神经精神病学临床评估量表（SCAN）访谈，18至65岁患者中符合国际疾病分类第10版（ICD - 10）精神障碍的比例（32%）高于65岁以上患者（16%）。同样，ICD - 10抑郁症在年轻患者（16%）中比老年患者组（11%）更常见。这些差异均无统计学意义。然而，多元回归分析显示，在其他风险因素中，年龄较小与精神障碍的存在显著相关。此外，使用一般健康问卷 - 28（GHQ - 28）（p < 0.01）和修订后的临床访谈量表（CIS - R）（p < 0.01）等筛查工具在较年轻年龄组中检测到的精神病例发生率显著更高。两个年龄组之间个体神经行为症状的发生率差异显著。18至65岁人群中最常见的症状是易怒（37%）和睡眠问题（37%）。在老年患者组中，最常见的症状是记忆力差（40%）、依赖（38%）和思维迟缓（33%）。