Disruptive behaviour disorders and disruptive symptoms after severe paediatric traumatic brain injury
Disruptive behaviour disorders and disruptive symptoms after severe paediatric traumatic brain injury
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DOI：
10.3109/02699050903285531
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发表时间：
2009-01-01
期刊：
影响因子：
1.9
通讯作者：
Vasa, Roma A.
中科院分区：
文献类型：
--
作者：
Gerring, Joan P.;Grados, Marco A.;Vasa, Roma A.
目的：了解儿童重型颅脑损伤(TBI)后DSM-III-R对立违抗性障碍(ODD)和品行障碍(CD)的伤前和伤后患病率，儿童重型颅脑损伤后破坏性症状的增加及其相关危险因素。受伤前和1年后的精神状态评估由家长报告确定。结果：颅脑损伤患者伤前ODD的患病率为6%，CD的患病率为8%，伤前CD的患病率显著高于对照人群。损伤后1年新发ODD和CD的发生率分别为9%和8%，新发CD的发生率显著高于参考人群。在受伤后的第一年，奇怪的症状和破坏性症状的总数显著增加。破坏性障碍/症状的显著危险因素包括伤害前较高的心理社会逆境、违纪行为等级和情感稳定性。结论：伤害前品行障碍是伤害后破坏性行为的重要危险因素。新发CD和破坏性症状是脑外伤后1年的后果。这些损伤后干扰的危险因素与非脑外伤人群中的危险因素相似。
Objective: To determine pre-injury prevalence and post-injury incidence of DSM-III-R oppositional defiant disorder (ODD) and conduct disorder (CD), increase in disruptive symptoms after severe paediatric traumatic brain injury (TBI) and risk factors associated with development of these disturbances.Methods: Ninety-four children were followed 1 one year after severe TBI. Assessments of pre-injury and 1-year psychiatric status were ascertained by parent report. The 1-year incidence of disruptive behaviour disorders/symptoms was the main outcome measure.Results: The pre-injury prevalence of ODD and CD in the TBI sample was 6% and 8%, respectively, the prevalence of pre-injury CD being significantly higher than in a reference population. The incidence of new-onset ODD and CD 1-year post-injury was 9% and 8%, respectively, the incidence of new-onset CD being significantly higher than in a reference population. ODD symptoms and total number of disruptive symptoms increased significantly over the first post-injury year. Significant risk factors for disruptive disorders/symptoms included higher pre-injury psychosocial adversity, delinquency ratings and affective lability.Conclusions: Pre-injury conduct disorder is a significant risk factor for post-injury disruptive behaviours. New-onset CD and disruptive symptoms are consequences of TBI at 1-year post-injury. Risk factors for these post-injury disturbances are similar to risk factors in non-TBI populations.