Post-traumatic stress disorder and self-reported outcomes after traumatic brain injury in victims of assault
Post-traumatic stress disorder and self-reported outcomes after traumatic brain injury in victims of assault
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DOI：
10.1371/journal.pone.0211684
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发表时间：
2019-02-07
期刊：
影响因子：
3.7
通讯作者：
Upthegrove, Rachel
中科院分区：
文献类型：
--
作者：
Bown, Dominic;Belli, Antonio;Upthegrove, Rachel
简介攻击是继跌倒和道路交通碰撞之后导致创伤性脑损伤 (TBI) 的第三大常见原因。 TBI 可导致多种长期的身体、认知和情感后遗症，包括创伤后应激障碍 (PTSD)。故意暴力可能会进一步加剧事件的心理创伤，而格拉斯哥结果量表（GOS）等传统结果衡量标准无法体现这一点。本研究旨在探讨攻击对自我报告结果的影响，包括生活质量和 PTSD 症状。方法问卷由 256 名前往 TBI 诊所就诊的患者完成，包括脑损伤后生活质量 (QOLIBRI) 和 PTSD 检查表 (PCL-C)。医疗记录提供了人口统计数据、临床数据和损伤病因学。比较了攻击和其他原因之间的主观结果。结果在分析的 202 名患者中，21% 的人因攻击而遭受 TBI。攻击组和非攻击组之间的伤害严重程度没有差异。自我报告的结果与 TBI 严重程度或 GOS 之间没有发现任何关系。攻击组在所有自我报告的问卷中得分较低，创伤后应激障碍和脑震荡后症状的测量具有统计学显着差异。然而，根据阈值评分，受攻击患者的 PTSD 患病率并不高于非攻击患者。在调整了年龄、种族和颅外伤的存在后，攻击行为对问卷得分没有显着影响。探索性分析表明，与跌倒相比，袭击和道路交通事故与明显更差的结果相关。结论 生活质量与 TBI 后的功能和心理结果显着相关。与其他患者相比，受袭击的患者的自我报告结果更差，但在根据人口因素进行调整后，这些差异并不显着。创伤事件背后的意图可能比单独的原因更重要。格拉斯哥结果量表没有反映生活质量和其他自我报告结果的差异。此信息对于安排早期和有针对性的审查和支持非常有用。
IntroductionAssault is the third most common cause of traumatic brain injury (TBI), after falls and road traffic collisions. TBI can lead to multiple long-term physical, cognitive and emotional sequelae, including post-traumatic stress disorder (PTSD). Intentional violence may further compound the psychological trauma of the event, in a way that conventional outcome measures, like the Glasgow Outcome Scale (GOS), fail to capture. This study aims to examine the influence of assault on self-reported outcomes, including quality of life and symptoms of PTSD.MethodsQuestionnaire were completed by 256 patients attending a TBI clinic, including Quality of Life after Brain Injury (QOLIBRI) and PTSD checklist (PCL-C). Medical records provided demographics, clinical data and aetiology of injury. Subjective outcomes were compared between assault and other causes.ResultsOf 202 patients analysed, 21% sustained TBI from assault. There was no difference in severity of injuries between assault and non-assault groups. No relationship was found between self-reported outcomes and TBI severity or GOS. The assault group scored worse in all self-reported questionnaires, with statistically significant differences for measures of PTSD and post-concussion symptoms. However, using threshold scores, the prevalence of PTSD in assaulted patients was not higher than non-assault. After adjusting for age, ethnicity and the presence of extra-cranial trauma, assault did not have a significant effect on questionnaire scores. Exploratory analysis showed that assault and road traffic accidents were associated with significantly worse outcomes compared to falls.ConclusionQuality of life is significantly related to functional and psychological outcomes after TBI. Assaulted patients suffer from worse self-reported outcomes than other patients, but these differences were insignificant when adjusted for demographic factors. Intentionality behind the traumatic event is likely more important than cause alone. Differences in quality of life and other self-reported outcomes are not reflected by the Glasgow Outcome Scale. This information is useful in arranging earlier and targeted review and support.