Secondary mania following traumatic brain injury.
Secondary mania following traumatic brain injury.
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DOI：
10.1097/00001199-199403000-00014
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发表时间：
1993-06
期刊：
影响因子：
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通讯作者：
R. Jorge;R. Robinson;S. Starkstein;Stephan Arndt;Forrester Aw;F. Geisler
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文献类型：
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作者：
R. Jorge;R. Robinson;S. Starkstein;Stephan Arndt;Forrester Aw;F. Geisler
目的在这项研究中，患者在创伤性脑损伤后的第一年进行检查，以确定是否存在继发性躁狂症。方法对66例闭合性颅脑损伤患者在医院进行了连续的3个月、6个月和12个月的随访。患者接受了半结构化精神病学访谈和日常生活活动、智力功能和社会功能障碍量表的检查。将符合DSM-III-R躁狂症标准的患者与重度抑郁症患者和无情感障碍患者的背景特征、损伤变量和病变位置进行比较。结果6例患者（9%）在随访期间的某个时间点符合躁狂症的标准。即使考虑到其他病变部位的影响，颞叶基底极病变的存在与继发性躁狂症显著相关。未发现继发性躁狂与脑损伤的严重程度、身体或认知障碍的程度、社会功能水平或既往精神障碍家族史或个人史相关。然而，躁狂的持续时间似乎很短，持续约2个月。结论：在这些创伤性脑损伤患者中，继发性躁狂症的发生率为9%，明显高于其他脑损伤人群（例如，中风患者）。主要的相关因素是存在颞基底极病变。
OBJECTIVE In this study patients were examined during the first year after traumatic brain injury to determine the presence of secondary mania. METHOD A consecutive series of 66 patients with closed-head injury were evaluated in the hospital and at 3-, 6-, and 12-month follow-ups. The patients were examined with a semistructured psychiatric interview and scales for measurement of impairment in activities of daily living, intellectual function, and social functioning. Patients fulfilling the DSM-III-R criteria for mania were compared to patients with major depression and to patients without affective disturbances in regard to their background characteristics, impairment variables, and lesion locations. RESULTS Six patients (9%) met the criteria for mania at some point during follow-up. The presence of temporal basal polar lesions was significantly associated with secondary mania even when the effect of other lesion locations was taken into account. Secondary mania was not found to be associated with the severity of brain injury, degree of physical or cognitive impairment, level of social functioning, or previous family or personal history of psychiatric disorder. The duration of mania, however, appeared to be brief, lasting approximately 2 months. CONCLUSIONS The 9% frequency of secondary mania in these patients with traumatic brain injury is significantly greater than that seen in other brain-injured populations (e.g., patients with stroke). The major correlate was the presence of a temporal basal polar lesion.