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创伤性脑损伤后的神经精神问题:揭示这一隐匿的流行病。

Neuropsychiatric problems after traumatic brain injury: unraveling the silent epidemic.

作者信息

Vaishnavi Sandeep, Rao Vani, Fann Jesse R

机构信息

Division of Geriatric Psychiatry and Neuropsychiatry, Dept. of Psychiatry and BehavioralSciences, The Johns Hopkins School of Medicine, USA.

出版信息

Psychosomatics. 2009 May-Jun;50(3):198-205. doi: 10.1176/appi.psy.50.3.198.

Abstract

BACKGROUND

Traumatic brain injury (TBI) is a significant public health concern. According to the Centers for Disease Control and Prevention, about 1.4 million people in the United States sustain a TBI annually.

OBJECTIVE

This review places particular emphasis on the current knowledge of effective treatment of TBI symptoms, and proposes directions for future research.

RESULTS

Neuropsychiatric problems are more prevalent and longer-lasting in TBI patients than in the general population. About 40% of TBI victims suffer from two or more psychiatric disorders, and a similar percentage experience at least one unmet need for cognitive, emotional, or job assistance 1 year after injury. The entire spectrum of TBI severity, from mild to severe, is associated with an increase in psychiatric conditions.

CONCLUSION

Despite the high incidence of severe consequences of TBI, there are scarce empirical data to guide psychiatric treatment. Some approaches that have been helpful include cognitive and behavioral therapy and pharmacologic treatment. The authors list specific research recommendations that could further identify useful therapeutic interventions.

摘要

背景

创伤性脑损伤(TBI)是一个重大的公共卫生问题。根据疾病控制与预防中心的数据,美国每年约有140万人遭受创伤性脑损伤。

目的

本综述特别强调了目前关于创伤性脑损伤症状有效治疗的知识,并提出了未来研究的方向。

结果

与普通人群相比,神经精神问题在创伤性脑损伤患者中更为普遍且持续时间更长。约40%的创伤性脑损伤受害者患有两种或更多种精神障碍,且相似比例的患者在受伤1年后至少有一项未满足的认知、情感或工作援助需求。从轻度到重度的整个创伤性脑损伤严重程度范围都与精神疾病的增加有关。

结论

尽管创伤性脑损伤严重后果的发生率很高,但指导精神治疗的实证数据却很匮乏。一些有用的方法包括认知行为疗法和药物治疗。作者列出了具体的研究建议,这些建议可以进一步确定有用的治疗干预措施。

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