A prospective study of children with head injures: III. Psychiatric sequelae

Psychological Medicine - Tập 11 Số 1 - Trang 63-78 - 1981
Gillian Brown, Oliver Chadwick, David Shaffer, Michael Rutter, Michael Traub

Tóm tắt

SYNOPSISA 2¼-year prospective study of children suffering head injury is described. Three groups of children were studied: (a) 31 children with ‘severe’ head injuries resulting in a post-traumatic amnesia (PTA) of at least 7 days; (b) an individually matched control group of 28 children with hospital-treated orthopaedic injuries; and (c) 29 children with ‘mild’ head injuries resulting in a PTA exceeding 1 hour but less than 1 week. A retrospective assessment of the children's pre-accident behaviour was obtained by parental interview and teacher questionnaire immediately after the accident and before the behavioural sequelae of the injury could be known. Further psychiatric assessments were undertaken 4 months, 1 year and 21 years after the initial injury. The mild head injury group showed a raised level of behavioural disturbance before the accident but no increase thereafter. It was concluded that head injuries resulting in a PTA of less than I week did not appreciably increase the psychiatric risk. By contrast, there was a marked increase in psychiatric disorders following severe head injury. The high rate of new disorders in children with severe head injuries who were without disorder before the accident, together with the finding of a dose–response relationship with the severity of brain injury, indicated a causal relationship. However, the development of psychiatric disorders in children with severe head injuries was also influenced by the children's pre-accident behaviour, their intellectual level, and their psychosocial circumstances. With the exception of social disinhibition and a slight tendency for the disorders to show greater persistence over time, the disorders attributable to head injury showed no specific features.

Từ khóa


Tài liệu tham khảo

10.1111/j.1469-7610.1967.tb02175.x

Rutter M. & Cox A. D. C. (1978). The Assessment of Diagnostic Interviewing Techniques in Child Psychiatry. Final Report to the SSRC.

Rutter, 1970, Education, Health and Behaviour

Schachar R. , Rutter M. & Smith A. (1980). Characteristics of situationally and pervasively hyperactive children: implications for syndrome definition. Journal of Child Psychology and Psychiatry (in the press).

10.1192/bjp.126.6.493

Rutter, 1977, Ecological Factors in Human Development, 173

Conners, 1973, Rating scales for use in drug studies in children, Pharmacotherapy of Children, 24

10.1007/BF00583828

10.1017/S0033291700053277

10.1016/S0140-6736(78)91097-8

10.1177/001872676601900301

Burton, 1968, Vulnerable Children

10.1136/bmj.4.5834.200

1976, Assessment Manual

10.1192/bjp.114.510.581

Lishman, 1978, Organic Psychiatry

10.2307/1127305

10.1136/adc.35.181.215

10.1017/S0033291700018201

10.1017/S0033291700054933

Shaffer, 1975, Outcome of Severe Damage to the Central Nervous System, 191

Wechsler, 1949, Wechsler Intelligence Scale for Children (Manual)

Chadwick O. , Rutter M. , Shaffer D. & Shrout P. (1981 b) A prospective study of children with head injuries: IV. Possible specific cognitive deficits. (Submitted for publication.)

10.1136/bmj.1.5119.409

Thông tin
Thông tin xuất bản

Psychological Medicine

Tập 11 Số 1

63-78

Thông tin tác giả