Greenham Mardee, Anderson Vicki, Hearps Stephen, Ditchfield Michael, Coleman Lee, Mackay Mark T, Monagle Paul, Gordon Anne L
Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Vic, Australia.
School of Psychological Sciences, University of Melbourne, Melbourne, Vic, Australia.
Dev Med Child Neurol. 2017 Oct;59(10):1027-1033. doi: 10.1111/dmcn.13387. Epub 2017 Jan 25.
Childhood stroke disrupts brain development and emerging neural networks. Motor, cognitive, and language deficits are well recognized, yet little is known about psychosocial function after childhood stroke. This study aims to describe psychosocial function within the first year after childhood stroke, and to identify factors associated with outcome.
Thirty-seven children were involved in a prospective, longitudinal study investigating recovery over the first year after childhood stroke. Children's social functioning was assessed at 6-months and 12-months poststroke and psychological function at 12-months poststroke, using standardized measures.
Mean social function was poorer at both 6-months and 12-months poststroke, compared to prestroke. Psychological problems were more common than expected, with emotional difficulties and hyperactivity-inattention most significantly affected. Poorer social function was associated with older age at onset, acute neurological impairment, and prestroke social impairment. Social and psychological problems were associated with parent mental health.
While not all children are affected, psychosocial impairment affects a significant minority after childhood stroke. Older age at onset, acute neurological impairment, prestroke social problems, and poorer parent mental health were associated with deficits. Identifying early predictors of poorer outcome will facilitate early intervention. Of particular importance is parent mental health, suggesting support for families may improve child outcome.
儿童期中风会扰乱大脑发育和新兴神经网络。运动、认知和语言缺陷已广为人知，但对于儿童期中风后的社会心理功能却知之甚少。本研究旨在描述儿童期中风后第一年的社会心理功能，并确定与预后相关的因素。
37名儿童参与了一项前瞻性纵向研究，调查儿童期中风后第一年的恢复情况。使用标准化测量方法，在中风后6个月和12个月评估儿童的社会功能，在中风后12个月评估心理功能。
与中风前相比，中风后6个月和12个月时的平均社会功能均较差。心理问题比预期更常见，情绪困扰和多动-注意力不集中受影响最为显著。较差的社会功能与发病时年龄较大、急性神经功能损害和中风前社会功能损害有关。社会和心理问题与父母心理健康有关。
虽然并非所有儿童都会受到影响，但儿童期中风后社会心理损害会影响相当一部分人。发病时年龄较大、急性神经功能损害、中风前社会问题以及父母心理健康较差与功能缺陷有关。识别预后较差的早期预测因素将有助于早期干预。特别重要的是父母心理健康，这表明对家庭的支持可能会改善儿童的预后。
