Alcohol and Drug Use Before and During the First Year After Traumatic Brain Injury
Alcohol and Drug Use Before and During the First Year After Traumatic Brain Injury
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DOI：
10.1097/htr.0000000000000341
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发表时间：
2018-05-01
影响因子：
2.4
通讯作者：
Ouellet, Marie-Christine
中科院分区：
文献类型：
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作者：
Beaulieu-Bonneau, Simon;St-Onge, Frederic;Ouellet, Marie-Christine
目的：比较轻度和中度/重度创伤性脑损伤 (TBI) 患者在 TBI 之前和之后第一年的酒精、药物使用和物质使用障碍情况；探索与物质使用障碍相关的社会人口统计学和伤害相关变量。参与者：TBI 后在一级创伤中心住院的总共 225 名成年人。设计：观察性队列研究，包括回顾性（TBI 前）和前瞻性（TBI 后 4、8 和 12 个月）评估。主要措施：《精神疾病诊断和统计手册》第四版迷你国际神经精神病学访谈(DSM-IV)。 结果：受伤后不久（4 个月），使用酒精或药物的参与者比例有所下降，但到第一年年底时增加到接近受伤前的水平。轻度 TBI 后酒精使用量高于中度/重度 TBI，但药物使用情况相似。大约 11% 的参与者在 TBI 后的第一年符合物质使用障碍的标准。年龄较小、没有恋爱关系以及 TBI 时疑似物质中毒与 TBI 后物质使用障碍的存在有关。结论：较轻损伤的个体比损伤较严重的个体更早恢复饮酒。鉴于药物使用可能会影响康复，因此无论受伤严重程度和康复情况如何，都需要采取预防性建议和系统性随访。
Objectives: To compare individuals with mild and moderate/severe traumatic brain injury (TBI) on alcohol and drug use and substance use disorders before and in the first year post-TBI; to explore sociodemographic and injury-related variables associated with substance use disorders.Participants: A total of 225 adults hospitalized in a level I trauma center after TBI.Design: Observational cohort study with retrospective (pre-TBI) and prospective (4, 8, and 12 months post-TBI) assessments.Main measures:Mini International Neuropsychiatric Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).Results: The percentage of participants using alcohol or drug declined shortly after the injury (4 months) but increased closer to preinjury levels by the end of the first year. Post-TBI alcohol use was higher after mild than moderate/severe TBI, but drug use was similar. About 11% of participants met criteria for a substance use disorder in the first year after TBI. Younger age, not being in a relationship, and suspected substance intoxication at the time of TBI were associated with the presence of a post-TBI substance use disorder.Conclusion: Individuals with milder injuries return to alcohol use earlier than those with more severe injuries. Given that substance use may alter recovery, preventive recommendations and systematic follow-ups are warranted regardless of injury severity and access to rehabilitation.