颅脑损伤所致精神障碍的相关因素研究

目的探讨颅脑损伤所致精神障碍的相关因素。方法以成都市公安交通管理局事故处理大队提供的因道路交通事故造成颅脑损伤的255名存活者为研究对象,在颅脑损伤治疗终结后进行智商测验、记忆商测验、SCID -I评估、PDQC和SCICP评估、脑电地形图检查,并完成人口学资料的收集。依据CCMD-3诊断标准中有关器质性精神障碍的分类进行精神障碍的诊断。结果 255例颅脑损伤患者中,罹患各类精神障碍者共185例,发生率为 72．5％。与颅脑损伤所致精神障碍相关的因素有:患者的文化程度低、脑挫裂伤、脑损伤程度重、左额叶和左颞叶损伤、多脑叶联合损伤及BEAM异常程度重。结论颅脑损伤所致精神障碍的发生率较高;患者的文化程度、颅脑损伤的性质、程度、部位及多脑叶联合损伤等因素对精神障碍的发生具有一定影响。

Study on the correlative factors for mental disorder in patients with head injury

Objective To explore the correlative factors of mental disorder in patients with head injury. Methods 255 subjects sustained with head injury and survived from traffic accident in Chengdu were assessed with Structured Clinical Interview for DSM-Ⅳ axis Ⅰ disorders (SCID-I/P) , Personality Disorder Questionaire for CCMD-2-R(PDQC), Structured Clinical Interview for CCMD-2-R(SCICP), WAIS-RC, WMS, brain electric activity mapping (BEAM) after completion of clinical management. Based on the diagnostic criteria of organic mental disorder in CCMD-3, mental disorders in 255 subjects were diagnosed. Results The incidence of mental disorders in the patients with head injury was 72.5% (185/255). Mental disorders in patients with head injury were correlated with educational level, type and severity of the head injury, or injuries involving the left frontal lobe injury, the left temporal lobe or multiple lobes and BEAM abnormality. Conclusion The incidence of mental disorder is high in the patients with head injury. Educational level, type and severity of the head injury, the location of the injured brain, injury involving multiple lobes of the brain may affect morbidity of mental disorders in patients with head injury.