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电击伤后的精神疾病发病率及其对认知功能的影响。

Psychiatric morbidity following electrical injury and its effects on cognitive functioning.

作者信息

Ramati Alona, Rubin Leah H, Wicklund Alissa, Pliskin Neil H, Ammar Alia N, Fink Joseph W, Bodnar Elena N, Lee Raphael C, Cooper Mary Ann, Kelley Kathleen M

机构信息

Department of Psychiatry, University of Illinois College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.

出版信息

Gen Hosp Psychiatry. 2009 Jul-Aug;31(4):360-6. doi: 10.1016/j.genhosppsych.2009.03.010. Epub 2009 May 9.

Abstract

OBJECTIVE

This study examines the prevalence of psychiatric morbidity in a large sample of electrical injury (EI) patients in three phases of recovery and its effects on cognitive functioning.

METHODS

Eight-six self-referred EI patients received psychiatric and neuropsychological evaluations. Descriptive statistics were conducted to examine the prevalence of psychiatric morbidity. Polytomous logistic regression was used to identify predictors of psychiatric diagnosis. Between-subjects analysis of variances (ANOVA) was conducted to examine the effects of psychiatric morbidity on cognitive functioning.

RESULTS

Seventy-eight percent of subjects warranted a psychiatric diagnosis. Long-term patients compared to acute patients were more likely to be diagnosed with two diagnoses than not having any diagnosis (OR=14.30, 95% CI 1.40-38.71). Patients with two diagnoses performed worse than both patients with a single or no diagnosis on all cognitive outcome measures (P<.05). Voltage level, chronic pain and litigation status did not predict psychiatric morbidity.

CONCLUSIONS

Psychiatric difficulties commonly emerge and persist following EI. EI patients with psychiatric conditions exhibited poorer cognitive performance as compared to EI patients with no post-injury psychiatric difficulties. Health care professionals need to devote careful attention to psychiatric and cognitive status when treating survivors of EI.

摘要

目的

本研究调查了大量电击伤(EI)患者在康复三个阶段的精神疾病患病率及其对认知功能的影响。

方法

86名自荐的EI患者接受了精神科和神经心理学评估。进行描述性统计以检查精神疾病的患病率。采用多分类逻辑回归来确定精神科诊断的预测因素。进行组间方差分析(ANOVA)以检查精神疾病对认知功能的影响。

结果

78%的受试者需要进行精神科诊断。与急性患者相比,长期患者被诊断出两种疾病而非未诊断出任何疾病的可能性更大(OR=14.30,95%CI 1.40-38.71)。在所有认知结果测量中,患有两种疾病的患者比患有单一疾病或未患病的患者表现更差(P<.05)。电压水平、慢性疼痛和诉讼状态不能预测精神疾病的发生。

结论

EI后精神问题常见且持续存在。与受伤后无精神问题的EI患者相比,患有精神疾病的EI患者认知表现较差。医疗保健专业人员在治疗EI幸存者时需要密切关注其精神和认知状态。

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