The Prevalence of Traumatic Brain Injury Among People With Co-Occurring Mental Health and Substance Use Disorders
The Prevalence of Traumatic Brain Injury Among People With Co-Occurring Mental Health and Substance Use Disorders
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DOI：
10.1097/htr.0000000000000249
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发表时间：
2017-05-01
影响因子：
2.4
通讯作者：
Drake, Robert E.
中科院分区：
文献类型：
--
作者：
McHugo, Gregory J.;Krassenbaum, Sarah;Drake, Robert E.
目的：评估精神健康和物质使用障碍共患病人群中创伤性脑损伤(TBI)的发生率和严重程度，并比较筛查阳性和阴性者之间的人口学、诊断学和机构学差异。地点：哥伦比亚区华盛顿的门诊社区精神卫生中心。参与者：共295名精神健康和物质使用障碍并存的患者参加药物滥用综合治疗的前瞻性研究。设计：横断面基线评估。主要测量方法：俄亥俄州立大学脑损伤鉴定方法。结果：80%的患者脑损伤筛查呈阳性，25%的患者报告至少有一次中度或重度脑损伤。脑外伤与当前饮酒和精神症状严重程度以及终生住院和无家可归有关。这在患有创伤后应激障碍、边缘人格障碍和反社会人格障碍的参与者中更为常见。男性(VS女性)和患有精神障碍的参与者(VS有情绪障碍的参与者)首次意识丧失的年龄较早。结论：TBI在精神健康和药物使用障碍共生的人群中很常见。反复严重的颅脑损伤在这一人群中很常见。在寻求综合治疗的共生疾病患者中，如果未能检测到脑损伤，可能会导致误诊和不适当的针对性治疗和康复。
Objective: To estimate the rate and severity of traumatic brain injury (TBI) among people with co-occurring mental health and substance use disorders and to compare demographic, diagnostic, and institutionalization differences between those who screen positive or negative.Setting: Outpatient community mental health center in Washington, District of Columbia.Participants: A total of 295 people with co-occurring mental health and substance use disorders enrolled in a prospective study of integrated treatment of substance abuse.Design: Cross-sectional baseline assessment.Main Measures: The Ohio State University TBI Identification Method. Standardized measures assessed psychiatric diagnoses, symptom severity, current and lifetime substance use, and history of institutionalization.Results: Eighty percent screened positive for TBI, and 25% reported at least 1 moderate or severe TBI. TBI was associated with current alcohol use and psychiatric symptom severity and with lifetime institutionalization and homelessness. It was more common among participants with posttraumatic stress disorder, borderline personality disorder, and antisocial personality disorder. Men (vs women) and participants with psychotic disorders (vs those with mood disorders) had an earlier age of first TBI with loss of consciousness.Conclusion: TBI is common among people with co-occurring mental health and substance use disorders. Repeated and serious TBIs are common in this population. Failure to detect TBI in people with co-occurring disorders who are seeking integrated treatment could lead to misdiagnosis and inappropriately targeted treatment and rehabilitation.