Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.
J Neurol Neurosurg Psychiatry. 2011 Jul;82(7):782-7. doi: 10.1136/jnnp.2010.228254. Epub 2011 Jan 17.
A subset of persons with mild traumatic brain injury (mTBI) experience long-term difficulties. Preinjury stress has been hypothesised to play a role in long-term maintenance of symptoms.
To investigate the predictive ability of preinjury stressful life events and post-traumatic stress symptoms to health-related quality of life and emotional distress after mTBI.
Within 2 weeks of injury, 186 participants with mTBI who were admitted to an emergency centre completed an interview and questionnaires regarding preinjury functioning, including the Stressful Life Events Questionnaire and the Post-Traumatic Stress Disorder Checklist. Outcomes were assessed at 3 months after injury and included the depression and anxiety subscales of the Brief Symptom Inventory, and the physical and mental component scores of the 36-item Short-Form Health Survey (SF-36). The incidence and type of stressful life events were reported. Hierarchical regression analyses were used to determine the predictive utility of Stressful Life Events Questionnaire and Post-Traumatic Stress Disorder Checklist after controlling for age, injury severity (complicated versus uncomplicated mild) and preinjury depression.
Several potentially life-altering stressful events were endorsed by at least 25% of participants as having been experienced prior to injury. The incidence of stressful life events was a significant predictor of all four outcome variables. History of post-traumatic stress symptoms was predictive of scores on the SF-36 mental health component.
A history of stressful events may predispose persons with mTBI to have poor outcomes. History of stress should be assessed during the early stages after mTBI to help identify those who could benefit from therapies to assist with adjustment and maximise recovery.
一部分轻度创伤性脑损伤（mTBI）患者会长期存在困难。受伤前的压力被假设在症状的长期维持中起作用。
调查受伤前的压力性生活事件和创伤后应激症状对 mTBI 后健康相关生活质量和情绪困扰的预测能力。
在受伤后 2 周内，186 名因 mTBI 入住急诊中心的患者完成了一项关于受伤前功能的访谈和问卷调查，包括压力性生活事件问卷和创伤后应激障碍检查表。在受伤后 3 个月评估结果，包括简明症状量表的抑郁和焦虑子量表，以及 36 项简短健康调查（SF-36）的身体和心理成分评分。报告了压力性生活事件的发生率和类型。使用分层回归分析确定压力性生活事件问卷和创伤后应激障碍检查表在控制年龄、损伤严重程度（复杂与非复杂轻度）和受伤前抑郁后对结果的预测效用。
至少 25%的参与者报告了一些可能改变生活的压力性生活事件。压力性生活事件的发生率是所有四个结果变量的显著预测因子。创伤后应激症状的病史是 SF-36 心理健康成分评分的预测因子。
压力事件的历史可能使 mTBI 患者更容易出现不良结果。在 mTBI 后的早期阶段应评估压力史，以帮助识别那些可能受益于治疗以帮助调整和最大限度地恢复的患者。
