South London and Maudsley NHS Trust, King's College Hospital, London, London, UK.
Dev Med Child Neurol. 2014 Jan;56(1):19-30. doi: 10.1111/dmcn.12237. Epub 2013 Aug 27.
The psychological and psychiatric outcome of children with acquired brain injury is influenced by many variables. A review was undertaken to clarify the contribution of family function, how it relates to injury severity, and what particular aspects of family function influence psychological outcome in this group.
A systematized review of the literature of studies published between 1970 and 2012 from OvidMedline, PsychoInfo, PsycARTICLES, and Cochrane was undertaken focusing on family function, injury severity, and psychiatric outcome.
Thirty-six papers met the inclusion criteria. Injury severity was linked to the development of organic personality change. Family function before injury, measured by the Family Assessment Device or the Clinical Rating Scale, had a statistically significant effect on general psychological functioning in six out of eight studies. Family function had a significant effect for oppositional defiant disorder and secondary attention-deficit-hyperactivity disorder. The effects of family function may differ depending on the age of the child and the severity of the injury. Some styles of parenting moderated recovery. After injury, family function was related to the child's contemporaneous psychiatric symptoms. The level of evidence for these papers was 3 or 4 (Oxford Centre for Evidence-based Medicine criteria).
Screening for some aspects of family functioning before injury and family function during the rehabilitation phase may identify children at risk of psychiatric disorders.
后天性脑损伤儿童的心理和精神结局受许多变量的影响。本文旨在通过综述阐明家庭功能的作用，以及其与损伤严重程度的关系，以及家庭功能的哪些特定方面会影响该群体的心理结局。
对 1970 年至 2012 年间在 OvidMedline、PsychoInfo、PsycARTICLES 和 Cochrane 发表的文献进行了系统综述，重点关注家庭功能、损伤严重程度和精神结局。
符合纳入标准的论文共 36 篇。损伤严重程度与器质性人格改变的发生有关。在 8 项研究中有 6 项研究表明，使用家庭评估工具或临床评定量表测量的损伤前家庭功能对一般心理功能有统计学意义的影响。家庭功能对对立违抗障碍和继发性注意缺陷多动障碍有显著影响。家庭功能的影响可能因儿童的年龄和损伤的严重程度而异。一些育儿风格对恢复有调节作用。受伤后，家庭功能与儿童同期的精神症状有关。这些论文的证据水平为 3 或 4 级（牛津循证医学中心标准）。
在受伤前和康复阶段筛查家庭功能的某些方面可能会识别出有精神障碍风险的儿童。
