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Depression and Post-Traumatic Brain Injury: Clinical and Neuropsychological Characteristics

Mauri MC, Paletta S, Di Pace C, Reggiori A, Cirnigliaro G and Miserocchi G

Major depression disorder (MDD) is reported to be the most frequent psychiatric complication after traumatic brain injury (TBI), with a prevalence of 14-77%.

The aim of this study was to evaluate the psychiatric consequences of TBI, and to identify the neuropsychological and psychopathological correlates of post-TBI MDD in order to highlight their differences from those of primary MDD.

This was a retrospective case-control study. Sixteen patients with closed brain injury, and a lesion revealed by computed tomography (CT), were recruited and were evaluated one (T1), three (T3) and six (T6) months after discharge from Neurosurgery Department; the control group consisted of six patients with MDD.

Psychiatric picture was evaluated by using the rating scales BPRS, HRSD, BDI, HRSA. GAF and IADL were also administered. Neuropsychological profiles were assessed by using neuropsychological tests, focused on memory and frontal-executive functioning.

At T1, MDD was observed in 10 cases (62.5%) and anxiety disorders in 6.25%. At T3 and T6, MDD was diagnosed in respectively 8 (50%) and 7 cases (44%). Post TBI MDD had less severe depressive symptoms “stricto sensu”, showed greater social isolation and hostility and more cognitive deficits in comparison with the control group.

MDD seem to be a frequent TBI complication. Patients with post-TBI MDD have a specific psychopathological profile characterised by a less severe depressive symptomatology and a neuropsychological pattern that is significantly associated with greater deficits in cognitive functions than those with primary MDD.