在mTBI之后需要更密集治疗的风险患者的识别:来自UPFRONT研究的后期洞察
Myrthe E Scheenen1, Harm J van der Horn, Myrthe E de Koning
1Author Affiliations: Departments of Neuropsychology (Dr Scheenen and Ms Spikman) and Neurology (Dr van der Horn and Ms van der Naalt), University of Groningen, University Medical Center Groningen, Groningen, Netherlands; and Department of Medical Psychology, Elisabeth-Tweesteden Hospital, Tilburg, Netherlands (Dr de Koning).
The Journal of head trauma rehabilitation
|March 7, 2024
概括
在轻度创伤性脑损伤 (mTBI) 后的两周内,焦虑和抑郁等心理症状预测了治疗的好处. 早期的心理评估,而不仅仅是症状投诉,可以改善患者选择预防性护理.
科学领域:
- 神经科学是一个神经科学.
- 心理学 心理学 心理学
- 康复医学 康复医学 康复医学
背景情况:
- 轻度创伤性脑损伤 (mTBI) 可以导致持续的症状和功能障碍.
- 识别那些不会从标准预防治疗中受益的患者对于优化护理至关重要.
- 之前的研究集中在创伤后的投诉,但心理因素可能更有预测性.
研究的目的:
- 确定预测危险mTBI患者预防性心理治疗反应不佳的因素.
- 确定早期心理症状是否比一般投诉更好地预测治疗结果.
主要方法:
- 一项随机对照试验的后期分析,涉及80名mTBI患者 (18-66岁) 面临着不良结果的风险.
- 患者接受了认知行为疗法或电话咨询.
- 双项逻辑回归被用于分析功能结果 (GOSE) 和12个月后返回工作/学习 (RTW) 的预测因素,基于受伤后2周收集的数据.
主要成果:
- 超过一半 (53.8%) 的患者有良好的功能结果,70%的患者在12个月内实现了完全的RTW.
- 不利的结局与更高的年龄,焦虑和抑郁症在2周和12个月后有关.
- 不成功的RTW与更高的年龄,抑郁症和创伤后应激障碍 (PTSD) 在2周和12个月后有关. 早期的焦虑和抑郁明显预测了功能结果,而年龄预测了RTW.
结论:
- 在mTBI后两周的心理测量是治疗效益和长期结果的重要预测指标.
- 根据早期的心理症状而不是一般的创伤后投诉,选择患者进行预防性干预可能更有效.
- 目前的短期预防性治疗可能对风险较高的mTBI患者的一个子集不够.
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