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首次创伤性脑损伤后新发抑郁的危险因素。

Risk Factors for New-Onset Depression After First-Time Traumatic Brain Injury.

机构信息

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.

出版信息

Psychosomatics. 2018 Jan-Feb;59(1):47-57. doi: 10.1016/j.psym.2017.07.008. Epub 2017 Jul 20.

Abstract

BACKGROUND

Major depression after traumatic brain injury (TBI) has devastating consequences as it increases the risk of suicide, impairs overall quality of life, and affects interpersonal, occupational, and social functioning. Although the literature has reported factors associated with depression after TBI, very few studies have examined the prevalence and correlates focused on the development of new-onset depression (NOD) after first-time TBI. Our study aimed to identify TBI- and non-TBI-related factors associated with the development of NOD in the first year after TBI.

METHODS

A total of 103 subjects with first-time TBI were seen within 12 months postinjury and evaluated for the development of NOD at 3, 6, and 12 months.

RESULTS

Frontal lobe functioning, frontal lesions, and pre-TBI/early post-TBI social impairment were not found to be predictors of development of NOD within the first year after injury. Decreased post-TBI social functioning as perceived by the subject at 3, 6, and 12 months was found to be associated with NOD at each of these time points, respectively.

CONCLUSION

The study findings highlight the importance of psychotherapeutic interventions to address the individuals' overall perception of their social impairment in the early-TBI period. This may help decrease the progression of major depression within the first year after injury.

摘要

背景

创伤性脑损伤 (TBI) 后发生的重度抑郁症会产生严重后果,因为它会增加自杀风险、损害整体生活质量,并影响人际关系、职业和社会功能。尽管文献已经报告了与 TBI 后抑郁相关的因素,但很少有研究检查过针对首次 TBI 后新发抑郁 (NOD) 发展的患病率和相关性因素。我们的研究旨在确定与 TBI 相关和非 TBI 相关的因素,这些因素与 TBI 后第一年 NOD 的发展有关。

方法

共 103 名首次 TBI 患者在受伤后 12 个月内就诊,并在 3、6 和 12 个月时评估 NOD 的发展情况。

结果

额叶功能、额叶病变以及 TBI 前/早期的社会功能障碍均未被发现是损伤后一年内 NOD 发展的预测因素。研究发现,患者在受伤后 3、6 和 12 个月时感知到的社会功能下降与每个时间点的 NOD 相关。

结论

研究结果强调了心理治疗干预的重要性,以解决个体在早期 TBI 期间对其社会功能障碍的整体认知。这可能有助于减少损伤后第一年重度抑郁症的进展。

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