Max J E, Dunisch D L
Department of Psychiatry, University of Iowa, Iowa City, USA.
J Am Acad Child Adolesc Psychiatry. 1997 Mar;36(3):404-11. doi: 10.1097/00004583-199703000-00020.
To demonstrate the similarity of children with a history of traumatic brain injury (TBI), particularly mild TBI, to matched children without such a history, within a child psychiatry outpatient clinic.
This is a chart review of patients presenting to a child psychiatry outpatient clinic over a 3-year period. Children with TBI were matched by age, sex, race, and social class to children with no history of TBI. Axis I and II diagnoses, use of special education services, and IQ scores were compared.
Seventy-four (5.6%) of 1,333 consecutive clinic cases had a definite TBI. Of these, 64 were mild. Only 3 of 59 comparisons that were made between TBI and control subjects were significant. A developmental communication disorder cluster was significantly more frequent in the TBI group. Autism and a pervasive developmental disorder cluster were significantly more frequent in the control group.
In a child psychiatry clinic, patients with a history of TBI are virtually indistinguishable from matched children without TBI. Caution should be exercised before attributing the child's problems, especially long-term problems, to the TBI unless the injury was severe or the child is exhibiting related phobic or posttraumatic stress symptomatology.
在儿童精神科门诊中，证明有创伤性脑损伤（TBI）病史的儿童，尤其是轻度TBI儿童，与匹配的无此类病史儿童的相似性。
这是一项对一家儿童精神科门诊在3年期间就诊患者的病历回顾。将有TBI的儿童与无TBI病史的儿童按年龄、性别、种族和社会阶层进行匹配。比较轴I和轴II诊断、特殊教育服务的使用情况以及智商分数。
在1333例连续的门诊病例中，74例（5.6%）有明确的TBI。其中，64例为轻度。在TBI组与对照组之间进行的59项比较中，只有3项具有显著性差异。发育性沟通障碍组在TBI组中明显更常见。自闭症和广泛性发育障碍组在对照组中明显更常见。
在儿童精神科门诊中，有TBI病史的患者与匹配的无TBI儿童几乎没有区别。在将儿童的问题，尤其是长期问题归因于TBI之前应谨慎，除非损伤严重或儿童表现出相关的恐惧或创伤后应激症状。
