Psychiatric illness following traumatic brain injury in an adult health maintenance organization population
Psychiatric illness following traumatic brain injury in an adult health maintenance organization population
复制标题
DOI：
10.1001/archpsyc.61.1.53
复制
发表时间：
2004-01-01
影响因子：
--
通讯作者：
Thompson, RS
中科院分区：
文献类型：
--
作者：
Fann, JR;Burington, B;Thompson, RS
背景：颅脑损伤后的精神疾病在住院和三级护理人群中普遍存在。目的：确定成人健康维护机构人群中颅脑损伤后精神疾病的风险。设计：前瞻性队列研究。背景：大型工作人员模式健康维护组织。参与者：939名健康计划成员，1993年被诊断为脑损伤，前一年未发现脑损伤。每个脑外伤暴露的受试者随机选择三个健康计划成员作为非暴露对照，年龄、性别和参考日期匹配。主要观察指标：脑损伤参考日期后3年的精神疾病，根据国际疾病分类、第九次修订、临床修改、处方和服务利用的计算机精神病学诊断记录确定。结果：第一年任何精神疾病的患病率在中到重度脑损伤后为49%，在轻度脑损伤后为34%，在对照组为18%。在前一年没有精神疾病的受试者中，中重度脑损伤后6个月内任何精神疾病的调整后相对风险为4.0(95%可信区间，2.4-6.8)，轻度脑外伤后6个月内任何精神疾病的调整后相对风险为2.8(95%可信区间，2.1-3.7；P
Background: Psychiatric illness after traumatic brain injury (TBI) has been shown to be prevalent in hospitalized and tertiary care patient populations.Objective: To determine the risk of psychiatric illness after TBI in an adult health maintenance organization population.Design: Prospective cohort study.Setting: Large staff-model health maintenance organization.Participants: Nine hundred thirty-nine health plan members diagnosed as having TBI in 1993 and enrolled in the prior year, during which no TBI was ascertained. Three health plan members per TBI-exposed subject were randomly selected as unexposed comparisons, matched for age, sex, and reference date.Main Outcome Measure: Psychiatric illness in the 3 years after the TBI reference date, determined using computerized records of psychiatric diagnoses according to the International Classification of Diseases, Ninth Revision, Clinical Modification, prescriptions, and service utilization.Results: Prevalence of any psychiatric illness in the first year was 49% following moderate to severe TBI, 34% following mild TBI, and 18% in the comparison group. Among subjects without psychiatric illness in the prior year, the adjusted relative risk for any psychiatric illness in the 6 months following moderate to severe TBI was 4.0 (95% confidence interval [CI], 2.4-6.8) and following mild TBI was 2.8 (95% CI, 2.1-3.7; P