Max J E, Smith W L, Sato Y, Mattheis P J, Castillo C S, Lindgren S D, Robin D A, Stierwalt J A
University of Iowa, Department of Psychiatry, Iowa City, USA.
J Am Acad Child Adolesc Psychiatry. 1997 Jan;36(1):94-102. doi: 10.1097/00004583-199701000-00022.
To assess predictive factors of psychiatric outcome in the first 3 months after traumatic brain injury (TBI) in children and adolescents.
Subjects were children aged 6 to 14 years at the time they were hospitalized after TBI. The study used a prospective follow-up design. Assessments of preinjury psychiatric, behavioral, adaptive functioning, family functioning, and family psychiatric history status were conducted. Severity of injury was assessed by standard clinical scales and neuroimaging was analyzed. The outcome measure was the development of a psychiatric disorder, never before present ("novel") in a subject during the first 3 months after the TBI.
Fifty subjects enrolled, and the analyses focused on 37 subjects followed up at 3 months. Increasing severity of injury, presence of a lifetime psychiatric disorder, family psychiatric history, family dysfunction, and lower socioeconomic class/preinjury intellectual function predicted the development of a "novel" psychiatric disorder in the first 3 months of follow-up.
These data suggest that there are children, identifiable through clinical assessment, at increased risk for development of psychiatric disorders in the first 3 months after TBI.
评估儿童和青少年创伤性脑损伤（TBI）后前3个月精神状态转归的预测因素。
研究对象为TBI住院时年龄在6至14岁的儿童。本研究采用前瞻性随访设计。对伤前精神、行为、适应功能、家庭功能及家族精神病史状况进行评估。通过标准临床量表评估损伤严重程度并分析神经影像学结果。转归指标为TBI后前3个月内研究对象出现既往未曾有过的精神障碍（“新发”）。
共纳入50名研究对象，分析聚焦于3个月时进行随访的37名研究对象。损伤严重程度增加、存在终生精神障碍、家族精神病史、家庭功能障碍以及较低的社会经济阶层/伤前智力功能可预测随访前3个月内“新发”精神障碍的发生。
这些数据表明，通过临床评估可识别出TBI后前3个月内发生精神障碍风险增加的儿童。
