Koponen Salla, Taiminen Tero, Hiekkanen Heli, Tenovuo Olli
Department of Psychiatry, University of Helsinki , Helsinki , Finland.
Brain Inj. 2011;25(11):1029-34. doi: 10.3109/02699052.2011.607783. Epub 2011 Aug 26.
To evaluate the occurrence of axis I and II psychiatric disorders among patients with traumatic brain injury (TBI).
Prospective observational study. Forty-five adult patients, who had attended an emergency unit because of TBI, were recruited. At 12 months, 38 patients were interviewed.
Psychiatric disorders were evaluated using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II).
Before TBI, the 12-month rate of axis I psychiatric disorders was relatively high (39.5%) and the rate of alcohol dependence was especially elevated (18.4%). During the 12 months after TBI, axis I disorders were found in 47.4% of subjects. Six patients (15.8%) were found to have a disorder with an onset after TBI. Of these, five patients had depressive disorders (13.2%). Almost one third of the subjects (29.0%) had personality disorders. Antisocial and obsessive-compulsive personality disorders were the most frequent (10.5%).
Both axis I and II psychiatric disorders are common among patients with TBI. Alcohol dependence and personality disorders are prevalent in individuals prone to TBI, whereas depressive disorders typically develop after injury. Psychiatric disorders should be addressed in rehabilitation, as otherwise they will hinder the recovery after TBI.
评估创伤性脑损伤（TBI）患者中轴I和轴II精神障碍的发生率。
前瞻性观察性研究。招募了45名因TBI就诊于急诊科的成年患者。在12个月时，对38名患者进行了访谈。
使用神经精神病学临床评估量表（SCAN）和DSM-IV人格障碍结构化临床访谈（SCID-II）评估精神障碍。
在TBI之前，轴I精神障碍的12个月发生率相对较高（39.5%），酒精依赖率尤其升高（18.4%）。在TBI后的12个月内，47.4%的受试者被发现患有轴I障碍。6名患者（15.8%）被发现患有TBI后起病的障碍。其中，5名患者患有抑郁症（13.2%）。近三分之一的受试者（29.0%）患有个性障碍。反社会和强迫性人格障碍最为常见（10.5%）。
轴I和轴II精神障碍在TBI患者中均很常见。酒精依赖和个性障碍在易患TBI的个体中普遍存在，而抑郁症通常在受伤后发生。精神障碍应在康复中得到处理，否则会阻碍TBI后的恢复。
