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蛛网膜下腔出血后的人格改变:系统评价和荟萃分析。

Personality changes after subarachnoid hemorrhage: A systematic review and meta-analysis.

机构信息

Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China.

Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China.

出版信息

J Psychosom Res. 2022 May;156:110762. doi: 10.1016/j.jpsychores.2022.110762. Epub 2022 Feb 14.

Abstract

OBJECTIVE

Personality changes (PC) comprise a common and debilitating illness that accompanies many neurological disorders, including non-traumatic subarachnoid hemorrhage (SAH). The aim of this systematic review was to identify and critically appraise all published studies that have reported the frequency, severity, and time course of PC after SAH, the factors associated with the development of PC and the effects of PC on patients' lives after SAH.

METHODS

We searched the PubMed, EMBASE, PsycINFO, and Ovid Nursing databases for studies published in English that recruited at least 10 patients (>18 years old) after SAH who were also diagnosed with PC.

RESULTS

We found eight studies involving 1227 patients met the study entry criteria. The frequency of PC ranged from 32% to 59%, with a pooled frequency of 44%. The clinical course of PC after SAH was unclear. PC after SAH may be associated with the clinical features and treatment factors related to SAH and comorbid conditions. Neurological signs, disability and surgical treatment increased the risk of PC. PC reduced the study participants' chance of employment.

CONCLUSION

In summary, PC commonly occurs after SAH. Further research is needed to clarify the time course of PC and identify the risk factors, neurochemical factors, and brain circuits associated with the development of post-SAH PC. Randomized controlled treatment trials targeting SAH-related PC are warranted.

摘要

目的

人格改变(PC)是一种常见且使人虚弱的疾病,伴随许多神经疾病,包括非创伤性蛛网膜下腔出血(SAH)。本系统评价的目的是确定和批判性评估所有已发表的研究,这些研究报告了 SAH 后 PC 的频率、严重程度和时间进程,与 PC 发展相关的因素以及 PC 对 SAH 后患者生活的影响。

方法

我们在 PubMed、EMBASE、PsycINFO 和 Ovid Nursing 数据库中搜索了以英语发表的研究,这些研究招募了至少 10 名 SAH 后被诊断为 PC 的患者(>18 岁)。

结果

我们发现了 8 项符合研究纳入标准的研究,涉及 1227 名患者。PC 的频率范围为 32%至 59%,汇总频率为 44%。SAH 后 PC 的临床过程尚不清楚。SAH 后 PC 可能与与 SAH 相关的临床特征和治疗因素以及合并症有关。神经体征、残疾和手术治疗增加了 PC 的风险。PC 降低了研究参与者就业的机会。

结论

总之,PC 在 SAH 后常见发生。需要进一步研究来阐明 PC 的时间进程,并确定与 SAH 后 PC 发展相关的风险因素、神经化学因素和大脑回路。针对与 SAH 相关的 PC 的随机对照治疗试验是必要的。

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