Psychiatric challenges in the first 6 years after traumatic brain injury: Cross-sequential analyses of axis I disorders
Psychiatric challenges in the first 6 years after traumatic brain injury: Cross-sequential analyses of axis I disorders
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DOI：
10.1016/j.apmr.2003.08.117
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发表时间：
2004-04-01
影响因子：
4.3
通讯作者：
Gordon, WA
中科院分区：
文献类型：
--
作者：
Ashman, TA;Spielman, LA;Gordon, WA
目的：研究颅脑损伤后6年内轴心功能障碍的发生率和预期发生率。设计：横断面、纵向和交叉序贯研究。地点：以社区为基础的研究和培训中心。参与者：188名在项目注册后4年内遭受过颅脑损伤的人，分别接受2次和3次评估。每项评估的时间间隔约为一年。分析了几个Axis I诊断，以检测横断面差异(按年龄和受伤后时间)和多个测量时间点上的平均个体变化。干预：不适用。主要结果：结构化临床访谈精神障碍诊断和统计手册。结果：每个受试者的优势比纵向变化，表明随着时间的推移，Axis I诊断的可能性降低。年龄上的横断面差异很小；因此，受伤时的年龄对Axis I的诊断几乎没有影响。损伤后的横截面时间与更多的精神障碍无关，而损伤前的横截面精神障碍史预示着损伤后的精神障碍。在控制了横断面效应后，在创伤后的第一次评估中，抑郁、焦虑和创伤后应激障碍中轴心I障碍的频率增加，而在随后的评估中下降。结论：控制横断面和纵向差异的交叉序贯分析对脑外伤后的精神障碍产生了更完整的描述。
Objective: To examine the preinjury rates of Axis I disorders and the prospective rates within the first 6 years after traumatic brain injury (TBI).Design: Cross-sectional, longitudinal, and cross-sequential.Setting: Community-based research and training center.Participants: Persons (N = 188) who had sustained TBI within 4 years of enrollment into the project were interviewed at either 2 and 3 assessments. Each assessment was approximately I year apart. Several Axis I diagnoses were analyzed to detect cross-sectional differences (by age and time postinjury) and average individual changes over the multiple measurement time points.Interventions: Not applicable.Main Outcome Measure: Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders.Results: The odds ratios changed longitudinally within each subject, indicating a decreased probability of having an Axis I diagnosis over time. There were few cross-sectional differences in age; therefore, age at the time of injury had little impact on Axis I diagnoses. Cross-sectional time since injury was not associated with more psychiatric disorders, whereas cross-sectional preinjury history of psychiatric disorders was predictive of postinjury psychiatric disorders. After controlling for cross-sectional effects, the frequencies of Axis I disorders increased in depression, anxiety, and posttraumatic stress disorders in the first assessment postinjury and declined in subsequent assessments.Conclusions: Cross-sequential analyses that control for cross-sectional and longitudinal differences produced a more complete description of psychiatric disorders after TBI.