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轻度创伤性脑损伤后急性应激障碍的早期评估及病程

Early stage assessment and course of acute stress disorder after mild traumatic brain injury.

作者信息

Broomhall Luke G J, Clark C Richard, McFarlane Alexander C, O'Donnell Meagan, Bryant Richard, Creamer Mark, Silove Derek

机构信息

School of Psychology, Flinders University, Adelaide, South Australia, Australia.

出版信息

J Nerv Ment Dis. 2009 Mar;197(3):178-81. doi: 10.1097/NMD.0b013e318199fe7f.

Abstract

Although it has been established that acute stress disorder (ASD) and posttraumatic stress disorder occur after mild traumatic brain injury (MTBI) the qualitative differences in symptom presentation between injury survivors with and without a MTBI have not been explored in depth. This study aimed to compare the ASD and posttraumatic stress disorder symptom presentation of injury survivors with and without MTBI. One thousand one hundred sixteen participants between the ages of 17 to 65 years (mean age: 38.97 years, SD: 14.23) were assessed in the acute hospital after a traumatic injury. Four hundred seventy-five individuals met the criteria for MTBI. Results showed a trend toward higher levels of ASD in the MTBI group compared with the non-MTBI group. Those with a MTBI and ASD had longer hospital admissions and higher levels of distress associated with their symptoms. Although many of the ASD symptoms that the MTBI group scored significantly higher were also part of a postconcussive syndrome, higher levels of avoidance symptoms may suggest that this group is at risk for longer term poor psychological adjustment. Mild TBI patients may represent a injury group at risk for poor psychological adjustment after traumatic injury.

摘要

尽管已经确定急性应激障碍(ASD)和创伤后应激障碍会在轻度创伤性脑损伤(MTBI)后出现,但尚未深入探讨有无MTBI的损伤幸存者在症状表现上的质性差异。本研究旨在比较有无MTBI的损伤幸存者的ASD和创伤后应激障碍症状表现。1116名年龄在17至65岁之间(平均年龄:38.97岁,标准差:14.23)的参与者在遭受创伤性损伤后于急症医院接受评估。475人符合MTBI标准。结果显示,与非MTBI组相比,MTBI组的ASD水平有升高趋势。患有MTBI和ASD的患者住院时间更长,且与症状相关的痛苦程度更高。尽管MTBI组得分显著更高的许多ASD症状也是脑震荡后综合征的一部分,但更高水平的回避症状可能表明该组存在长期心理调适不良的风险。轻度TBI患者可能是创伤性损伤后心理调适不良的高危损伤群体。

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