Jorge R E, Robinson R G, Starkstein S E, Arndt S V, Forrester A W, Geisler F H
Department of Psychiatry, College of Medicine, University of Iowa.
Am J Psychiatry. 1993 Jun;150(6):916-21. doi: 10.1176/ajp.150.6.916.
In this study patients were examined during the first year after traumatic brain injury to determine the presence of secondary mania.
A consecutive series of 66 patients with closed-head injury were evaluated in the hospital and at 3-, 6-, and 12-month follow-ups. The patients were examined with a semistructured psychiatric interview and scales for measurement of impairment in activities of daily living, intellectual function, and social functioning. Patients fulfilling the DSM-III-R criteria for mania were compared to patients with major depression and to patients without affective disturbances in regard to their background characteristics, impairment variables, and lesion locations.
Six patients (9%) met the criteria for mania at some point during follow-up. The presence of temporal basal polar lesions was significantly associated with secondary mania even when the effect of other lesion locations was taken into account. Secondary mania was not found to be associated with the severity of brain injury, degree of physical or cognitive impairment, level of social functioning, or previous family or personal history of psychiatric disorder. The duration of mania, however, appeared to be brief, lasting approximately 2 months.
The 9% frequency of secondary mania in these patients with traumatic brain injury is significantly greater than that seen in other brain-injured populations (e.g., patients with stroke). The major correlate was the presence of a temporal basal polar lesion.
在本研究中，对创伤性脑损伤后的第一年患者进行检查，以确定继发性躁狂症的存在情况。
对连续的66例闭合性颅脑损伤患者在医院及3个月、6个月和12个月随访时进行评估。采用半结构化精神科访谈以及测量日常生活活动、智力功能和社会功能损害程度的量表对患者进行检查。将符合DSM-III-R躁狂症标准的患者与重度抑郁症患者以及无情感障碍的患者在背景特征、损害变量和病变部位方面进行比较。
6例患者（9%）在随访期间的某个时间点符合躁狂症标准。即使考虑到其他病变部位的影响，颞叶基底极病变的存在与继发性躁狂症显著相关。未发现继发性躁狂症与脑损伤的严重程度、身体或认知损害程度、社会功能水平或既往家族或个人精神病史有关。然而，躁狂症的持续时间似乎较短，约为2个月。
这些创伤性脑损伤患者中继发性躁狂症9%的发生率显著高于其他脑损伤人群（例如中风患者）。主要相关因素是颞叶基底极病变的存在。
