Max J E, Castillo C S, Robin D A, Lindgren S D, Smith W L, Sato Y, Arndt S
Department of Psychiatry, University of Iowa, Iowa City, USA.
J Nerv Ment Dis. 1998 Oct;186(10):589-96. doi: 10.1097/00005053-199810000-00001.
The purpose of this study was to quantify and to identify predictors of posttraumatic stress disorder (PTSD) symptomatology after traumatic brain injury (TBI). Fifty children aged 6 to 14 years, hospitalized after TBI, were assessed soon after TBI regarding injury severity and preinjury psychiatric, socioeconomic, family functioning, and family psychiatric history status; neuroimaging was also analyzed. Psychiatric assessments were repeated 3, 6, 12, and 24 months after TBI. Only 2 of 46 (4%) subjects with at least one follow-up assessment developed PTSD. However, the frequency with which subjects experienced at least one PTSD symptom ranged from 68% in the first 3 months to 12% at 2 years in assessed children. The presence of an internalizing disorder at time of injury followed by greater injury severity were the most consistent predictors of PTSD symptomatology. It is apparent, therefore, that PTSD and subsyndromal posttraumatic stress disturbances occur despite neurogenic amnesia. These problems should be treated, particularly if symptoms persist beyond 3 months.
本研究的目的是量化并确定创伤性脑损伤（TBI）后创伤后应激障碍（PTSD）症状的预测因素。50名6至14岁因TBI住院的儿童，在TBI后不久就损伤严重程度以及伤前精神状况、社会经济状况、家庭功能和家族精神病史状况进行了评估；还对神经影像学进行了分析。在TBI后3、6、12和24个月重复进行精神评估。在至少接受一次随访评估的46名受试者中，只有2名（4%）出现了PTSD。然而，在接受评估的儿童中，至少出现一种PTSD症状的频率在前3个月为68%，在2年时为12%。受伤时存在内化障碍且损伤严重程度更高是PTSD症状最一致的预测因素。因此，很明显，尽管存在神经源性遗忘症，PTSD和亚综合征创伤后应激障碍仍会发生。这些问题应予以治疗，尤其是如果症状持续超过3个月。
