A Study on the Psychosocial Characteristics and Quality of Life in Functional Gastrointestinal Disorders / 정신신체의학

OBJECTIVES: This study aimed to compare the psychosocial characteristics among patients with functional gastrointestinal disorder (FGID), adults with functional gastrointestinal symptoms, and normal control group and investigate factors related to quality of life (QoL) of FGID patients. METHODS: 65 patients diagnosed with FGID were selected. 79 adults were selected as normal control group based on the Rome III diagnostic criteria, and 88 adults who showed functional gastrointestinal symptoms were selected as “FGID positive group”. Demographic factors were investigated. Psychosocial factors were evaluated using the Korean-Beck Depression Inventory-II, Korean-Beck Anxiety Inventory, Korean-Childhood Trauma Questionnaire, Multi-dimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale and WHO Quality of Life Assessment Instrument Brief Form. A one-way ANOVA was used to compare differences among groups. Pearson correlation test was used to analyze correlations between QoL and psychosocial factors in patients with FGID. RESULTS: There were group differences in the education level. Depression (F=29.012, p<0.001), anxiety (F=27.954, p<0.001) and Childhood trauma (F=7.748, p<0.001) were significantly higher in FGID patient group than in both FGID-positive and normal control group. Social support (F=5,123, p<0.001), Resilience (F=9.623, p<0.001) and QoL (F=35.991, p<0.001) were significantly lower in the FGID patient group than in others. QoL of FGID patients showed a positive correlation with resilience (r=0.475, p<0.01), and showed a negative correlation with depression (r=−0.641, p<0.01), anxiety (r=−0.641, p<0.01), and childhood trauma (r=−0.278, p<0.05). CONCLUSIONS: FGID patients have distinctive psychosocial factors compared to the both FGID-positive and normal control group. Therefore, the active interventions for psychosocial factors are required in the treatment of patients with FGID.

A Study of Psychosocial Factor Affecting Attitude Toward Suicide of Adult Male and Female Inhabiting in a Province / 우울ㆍ조울병

BACKGROUND: Individual attitudes toward suicide are known to markedly influence suicidal ideation and suicidal behavior. Therefore, this study aimed to determine the factors associated with attitudes toward suicide.METHODS: This study was conducted on 3,213 adult men and women living in a province of Korea. After excluding 281 participants because of unreliable responses, the remaining 2,932 were included in the data analysis. Demographic factors were investigated, and psychological factors were evaluated. Attitudes toward suicide were evaluated using the Attitudes Towards Suicide-20, physical symptoms were evaluated using the Patient Health Questionnaire-15 (PHQ-15), self-compassion was evaluated using the Korean Self-Compassion Scale, and stress was evaluated using the Global Assessment of Recent Stress (GARS) scale. One-way analysis of variance was used to examine the psychological characteristics of attitudes toward suicide.RESULTS: Differences in various factors based on demographic characteristics were observed regarding attitudes toward suicide. Significant differences in attitudes toward suicide were observed based on severity of suicide, acceptability (F=20.332, p<0.001), prevention of suicide (F=7.700, p<0.001), and universality (F=13.741, p<0.001). The duration of suicidal ideation, self-kindness, self-judgment, common humanity, isolation, and over-identification showed differences, as did the GARS and PHQ-15 scores.CONCLUSION: This study explored the demographic and psychological factors affecting attitudes toward suicide. Adequate mediation of these factors is needed to prevent suicidal ideation and behavior.

Psychosocial Factors Influence the Functional Gastrointestinal Disorder among Psychiatric Patients / 정신신체의학

OBJECTIVES: This study aimed to investigate the psychosocial characteristics of functional gastrointestinal disorder (FGID) in patients with psychiatric disorders. METHODS: This study was conducted with 144 outpatients visiting the psychiatric clinic at a university hospital. FGIDs were screened according to the Rome III questionnaire-Korean version. Demographic factors were investigated, and psychosocial factors were evaluated using the Hospital Anxiety Depression Scale, Patient Health Questionnaire-15, Childhood Trauma Questionnaire-Korean, and State-Trait Anger Expression Inventory. Chi-squared test and student's t-test were used as statistical analysis methods. RESULTS: There were differences in education level between two groups divided according to FGID status (χ²=10.139, p=0.017). Comparing the psychiatric disorder by FGID group, irritable bowel syndrome (IBS) group showed significant differences (χ²=11.408, p=0.022). According to FGID status, IBS group showed significant differences for anxiety (t=−3.106, p=0.002), depressive symptom (t=−2.105, p=0.037), somatic symptom (t=−3.565, p < 0.001), trait anger (t=−3.683, p < 0.001), anger-in (t=−2.463, p=0.015), and anger-out (t=− 2.355, p=0.020). Functional dyspepsia group showed significant differences for anxiety (t=−4.893, p < 0.001), depressive symptom (t=−3.459, p < 0.001), somatic symptom (t=−7.906, p < 0.001), trait-anger (t=−4.148, p < 0.001), state-anger (t=−2.181, p=0.031), anger-in (t=−2.684, p=0.008), and anger-out (t=−3.005, p=0.003). Nonerosive reflux disease group showed significant differences for anxiety (t=−4.286, p < 0.001), depressive symptom (t=−3.402, p < 0.001), somatic symptom (t=−7.162, p < 0.001), trait anger (t=−2.994, p=0.003), state anger (t=−2.259, p=0.025), anger-in (t=−2.772, p=0.006), and anger-out (t=−2.958, p=0.004). CONCLUSIONS: Patients with psychiatric disorders had a high prevalence of FGID, and various psychosocial factors contributed to such differences. Therefore, the psychiatric approach can offer better understandings and treatments to patients with FGID.

Differential Response Style on the Personality Assessment Inventory according to Compensation-Seeking Status in Patients with Traumatic Brain Injury / 정신신체의학

OBJECTIVES: This study examined the characteristics and differences of PAI(Personality Assessment Inventory) profile between compensation-seeking(CS) and treatment-seeking(TS) patients with traumatic brain injury(TBI) and assessed the clinical meaning of the characteristics and differences of profiles between the two groups. METHODS: 36 TBI patients who visited the Wonkwang University Hospital were selected. The patients were categorized as compensation-seeking TBI patients(n=22) and treatment-seeking TBI patients(n=14). The PAI scales and subscales were used to compare differences between two groups. t-verification for each variable and comparison analysis were performed. RESULTS: In validity scales, CS group showed significantly higher NIM scores and lower PIM scores than TS groups. In full scales, CS group showed significantly higher SOM, ANX, ARD, DEP, and SCZ scores than TS group. In subscales, CS group showed significantly higher SOM-S, ANX-A, ARD-P, DEP(-C, A, P), (MAN-I), PAR-H, SCZ(-T, P), BOR(-A, N), and ANT-S scores than TS groups. In supplementary scales, CS group showed significantly higher SUI, NON and AGG-P, and lower RXR scores than TS group. CONCLUSIONS: There were significant differences in PAI scales with validity scales, some full and subscales according to compensation seeking status in TBI patients. The CS patients tended to exaggerate their symptoms on PAI, and showed higher scores representing somatic preoccupation and emotional distress. These results show the usefulness of PAI in reflecting the significant psychological differences between two groups.

Executive Dysfunction and It's Relation to K-WAIS Scores in Mild Traumatic Brain Injury Patients with Normal Intelligence Quotient / 정신신체의학

OBJECTIVES: This study examined the selective deficits of executive function in patients with mild traumatic brain injury that in normal range of general intelligence level and aimed to analysis of the correlation between K-WAIS result and executive function. METHODS: 59 subjects were included in this study, who were diagnosed as mild traumatic brain injury(MTBI) and they have visited in neuropsychiatric department of Wonkwang University Hospital during from March, 2005 to September, 2010. For measurement of general intelligence quotient, the Korean-Wechsler Adults Intelligence Scale(K-WAIS) was administered and for measurement of executive intelligence quotient(EIQ), Executive Intelligence Test(EXIT) was administered. RESULTS: Of patients, 50.8% included at abnormal EIQ group. The patients of abnormal EIQ showed poorer full scale IQ(FIQ), performance IQ(PIQ) and in subscale that picture arrangement, digit symbol, digit span, block design, object assembly and comprehension were significantly different. In terms of relationships between K-WAIS and EIQ, FIQ and PIQ have positive correlation with EIQ. And in subscale, picture arrangement, digit symbol, digit span, block design, object assembly and comprehension show positive correlation with EIQ. CONCLUSION: This study suggest that MTBI patients with have normal range of general intelligence level may have deficit of executive function is common. The decline of FIQ, PIQ and some subscales of K-WAIS may suggest executive dysfunction in MTBI patients.

Multicenter Clinical Trials for Efficacy and Safety of Mirtazapine in Moderate-to-Severe Major Depressive Patients / 대한정신약물학회지

OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of mirtazapine treatment in multicenter population consisting of Korean patients suffering from moderate-to-severe depression. METHODS: Total 163 of in and outpatients with a diagnosis of major depressive disorder (DSM-IV) and 18 or over scores of 17-items Hamilton Rating Scale for Depression (HAMD) received treatment with mirtazapine (15-45 mg/day) for 6 weeks. Efficacy was assessed by HAMD, Montgomery and Asberg Depression Rating Scale (MADRS), Beck's Depression Inventory (BDI), and Clinical Global Impression (CGI) scales and statistical analyses were performed on the intent-to-treat sample (143 patients) using the last-observation-carried-forward method. In addition, reported adverse events, routine laboratory parameters, and vital signs were investigated to evaluate the safety of mirtazapine. RESULTS: Mean daily dose of mirtazapine was 28.4 mg. At the end of the study, the response rate (50% or more reduction from baseline in HAMD scores) was 75.5% and the remission rate (7 or less in HAMD score) was 42.7%. Mirtazapine treatment induced significant reduction in depressive symptoms at the 4(th) day and substantial reduction along the treatment period, as assessed by changes in HAMD, MADRS, BDI, and CGI scales. At the 4(th) day and first week of mirtazapine treatment, the mean HAMD-17 total score was significantly reduced compared that of the baseline and the response rates were 11.9% and 28.7%, respectively. Mirtazapine was well tolerated in general, and somnolence and sedation were the most common adverse events reported. In addition, there were no clinically relevant changes in laboratory parameters and vital signs, although body weight was increased. CONCLUSION: Although this trial had many limitations of open non-comparative study, mirtazapine was demonstrated to an effective treatment for moderate to severe major depressive disorder and was well tolerated. A potentially rapid onset of overall therapeutic efficacy of mirtazapine was suggested by significant changes in all major variables of efficacy after 4(th) day of treatment.

Personality Assessment Inventory Profiles of Patients with Mild and Severe Traumatic Brain Injury

OBJECTIVES: This study was designed to investigate the characteristics of personality changes and emotional distress using the Personality Assessment Inventory (PAI) in patients with traumatic brain injury(TBI), divided into mild (MTBI) and severe (STBI) groups according to the severity of injury. METHODS: The subjects were consisted of 25 patients with MTBI, 25 patients with STBI, and 25 normal controls. They were interviewed with the PAI. The data were analyzed by chi-square test, analysis of variance and Tukey test. RESULTS: The results were the followings. First, Negative Impression in validity scales was elevated above cutoff point(T score 70) in both MTBI and STBI groups. Second, the clinical scales of which scores elevated above the cutoff point were Somatic Complaints, Anxiety, Anxiety-Related Disorders, epression, and Schizophrenia in the MTBI, and Somatic Complaints and Depression in the STBI. Third, the clinical subscales above the cutoff point were Conversion, Somatization, Health Concerns, Affective Anxiety, Physiological Anxiety, Traumatic Stress, Cognitive Depression, Affective Depression, Physiological Depression, Thought Disorder, and Affective Instability in the MTBI, and Health Concerns, Cognitive Depression, Affective Depression, and Physiological Depression in the STBI. Fourth, Suicide Ideation in treatment scales was the only scale above the cutoff point in the MTBI and the others of the treatment and interpersonal scales in the MTBI and all of these scales of the STBI were not elevated above the cutoff point. Fifth, the scales of which scores showed significant difference between the MTBI and the STBI were Somatic Complaints, Anxiety, Depression, and Suicide Ideation, the subscales were Conversion, Somatization, Health Concerns, Affective Anxiety, Physiological Anxiety, Physiological Depression, and Psychotic Experiences. CONCLUSION: These results suggest that the patients with MTBI had more somatic and anxiety symptoms, depressed mood, and suicidal ideation than the patients with STBI. These characteristics are generally consistent with clinical observation and findings from previous studies of the patients with TBI, and the PAI seems to be a beneficial adjunctive assessment tool for the evaluation of patients with traumatic brain injury.

Psychosocial Outcome 5 Years after Assessment of Disability in Patients with Traumatic Brain Injury / 신경정신의학

OBJECTIVES: This study was designed to investigate the long-term psychosocial outcome of the patients with traumatic brain injury (TBI) about five years after initial assessment of disability. The psychosocial outcome was evaluated in the areas of cognitive function, neurobehavioral symptoms, socio-occupational function, purpose of life, and quality of life. METHODS: Twenty seven patients with TBI (TBI-S) were selected, who had admitted to the department of Neuropsychiatry of the Wonkwang University Hospital with a primary diagnosis of TBI for the initial assessment of disability during the period 1994-1998. At first, the author assessed their functions with the Neurobehavioral Rating Scale, Social Occupational Functioning Assessment Scale, and Quality of Life Index. And the patients completed the Korean Wechsler Adult Intelligence Scale, Rey-Kim Memory Test and Kims Executive Function Test, the Head Injury Symptom Checklist, Korean version of SmithKline Beecham Quality of Life Scale and Purpose-in-Life Test. The data from the TBI-S were compared between those from the TBI patients (TBI-C) who had received brain injury at the similar time and the TBI-S and admitted for the assessment of disability. RESULTS: Although there was no significant difference between the two TBI groups in the areas of cognitive function, such as general intelligence, verbal comprehension, visuo-spatial function, attention, memory, and executive function, the TBI-S showed significantly lower neurobehavioral symptoms, higher socio-occupational functioning, and higher purpose in life and quality of life levels than the TBI-C. Though 5 years had passed since injury the TBI-S still had various emotional and somatic symptoms and remained at the relatively lower levels in psychosocial functioning. CONCLUSION: The overall long-term psychosocial outcome of the TBI patients depends significantly on the status at the initial assessment of disability about 5 years ago. The improvement was seen in the areas of neurobehavioral symptoms and socio-occupational functioning but not in cognitive function. In spite of the improvement in some areas they still remained at relatively low levels in purpose-in-life and quality of life. This findings suggest that the specialized medical and social support is needed for their rehabilitation.

Psychosocial Outcome 5 Years after Assessment of Disability in Patients with Traumatic Brain Injury / 신경정신의학

OBJECTIVES: This study was designed to investigate the long-term psychosocial outcome of the patients with traumatic brain injury (TBI) about five years after initial assessment of disability. The psychosocial outcome was evaluated in the areas of cognitive function, neurobehavioral symptoms, socio-occupational function, purpose of life, and quality of life. METHODS: Twenty seven patients with TBI (TBI-S) were selected, who had admitted to the department of Neuropsychiatry of the Wonkwang University Hospital with a primary diagnosis of TBI for the initial assessment of disability during the period 1994-1998. At first, the author assessed their functions with the Neurobehavioral Rating Scale, Social Occupational Functioning Assessment Scale, and Quality of Life Index. And the patients completed the Korean Wechsler Adult Intelligence Scale, Rey-Kim Memory Test and Kims Executive Function Test, the Head Injury Symptom Checklist, Korean version of SmithKline Beecham Quality of Life Scale and Purpose-in-Life Test. The data from the TBI-S were compared between those from the TBI patients (TBI-C) who had received brain injury at the similar time and the TBI-S and admitted for the assessment of disability. RESULTS: Although there was no significant difference between the two TBI groups in the areas of cognitive function, such as general intelligence, verbal comprehension, visuo-spatial function, attention, memory, and executive function, the TBI-S showed significantly lower neurobehavioral symptoms, higher socio-occupational functioning, and higher purpose in life and quality of life levels than the TBI-C. Though 5 years had passed since injury the TBI-S still had various emotional and somatic symptoms and remained at the relatively lower levels in psychosocial functioning. CONCLUSION: The overall long-term psychosocial outcome of the TBI patients depends significantly on the status at the initial assessment of disability about 5 years ago. The improvement was seen in the areas of neurobehavioral symptoms and socio-occupational functioning but not in cognitive function. In spite of the improvement in some areas they still remained at relatively low levels in purpose-in-life and quality of life. This findings suggest that the specialized medical and social support is needed for their rehabilitation.

Combined Antitumor Chemotherapy in a Refractory Schizophrenic Receiving Clozapine / 신경정신의학

It has been known that clozapine treatment combining with cytotoxic antitumor therapy for schizophrenia is not recommended because both durgs have agranulocytosis as their side effect. Since the introduction of granulocyte colony-stimulating factor(G-CSF), it has been used to treat agranulocytosis or granulocytopenia associated with antitumor chemotherapy or clozapine. We report a case with schizophrenia on clozapine treatment who developed agranulocytosis following combined cytotoxic chemotherapy for a sex-cord stromal tumor which was successfully treated with G-CSF. The hematological status before combining with antitumor chemotherapy had been within normal range, and agranulocytosis following the antitumor chemotherapy returned to normal after treatment with G-CSF. This suggests that clozapine could be administered in combination with cytotoxic antitumor agents if the following indications are met : normal hematological status before starting antitumor chemotherapy, carefully monitoring hematological status by oncologist and psychiatrist, and prepared G-CSF administration when agranulocytosis is anticipated.

Effect of Tetrahydro-9-Aminoacridine on Acetylcholine Release in the Rat Hippocampus / 대한정신약물학회지

It is well known that the cholinergic innervation of hippocampal formation plays an important role in the process of memory and learning, and the deficit of this system might be a cause of the senile dementia including Alzheimer's disease. Several studies have suggested that increased central cholinergic activity could improve the cognitive deficits of the senile dementia. Therefore, many attempts have been made to reverse theses cognitive impairment by enhancing the central cholinergic activity through the use of cholinomimetics such as ACh precusor, cholinesterase(ChE) inhibitors and direct cholinoceptor agonists. Since Summers et al. reported that tacrine is worthy of novice as a possible palliative treatment for Alzheimer's disease, it has been shown to improve the memory and cognitive functions in some patients. Although tacrine is a potent centrally cholinesterase inhibitor, it seems unlikely that this property alone could underlie its clinical effect. Because the eserine, a specific cholinesterase inhibitor, showed little improvement in such patients, it is possible that tacrine may act in a different way to produce its clinical efforts. There are reports that tacrine blocked the some types of cation channels and the muscarinic receptors, and stimulated the nicotinic receptors in the central nervous system. After all, though a large body of experimental data have been accumulated, the mechanism controlling ACh release be tacrine still remains to be elucidated. In attempt to address the abode issue, this study was designed to delineate the action mechanism of tacrine on the electrically-evoked ACh release in the rat hippocampus.

Efficacy and Safety Profile of Risperidone in Schizophrenia: Long-term Follow-up Study / 신경정신의학

OBJECTIVES: The purpose of this study was to evaluate the long-term efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. METHOD: This multicenter open label study included 116 schizophrenic patients drawn from 19 university hospitals. After a wash-out period of 1 week, the patients were treated with risperidone for 56 weeks and evaluated at 8 points:at baseline, and the 8th, 16th, 24th, 32nd, 40th, 48th, 56th weeks of treatment. The dose was started at 2mg of risperidone on day 1, and increased to 4mg on day 2, and 6mg on day 3,7 and adjusted to a maximum of 16mg/day according to the individual's clinical response. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. RESULTS: Eighty-seven(75%) of 116 patients completed the 56-week trial of risperidone. Clinical improvement(as defined by a 20% of reduction in total PANSS score at end point) was shown by 92.0% of the patients. The mean dose of risperidone was 5.0mg/day in the 56 week follow-up. PANSS total scores showed significant improvements between consecutive two points at baseline, 8th, 16th, 24th, 32nd, and 48th week of treatment. CGI scores showed significant reductions between consecutive two points at baseline, 8th, 16th, 24th, and 48th week of treatment. Three PANSS factors(positive, negative, general) showed a significant improvement from the 8th week of treatment, and, after then, remained improved in the rest of the study period. ESRS showed no significant change during the 56 week trial. Laboratory parameters showed no significant changes during the course of treatment. CONCLUSIONS: This multicenter long-term open study suggests that risperidone is a antipsychotic drug with long term efficacy and safety in the treatment of schizophrenic patients.

Quality of Life Level in the Patients with the Sequelae of Traumatic Brain Injury: Comparing Mild to Severe Cases / 신경정신의학

This study was designed to investigate the differences of quality of life(QOL) between traumatic brain injury(TBI) and control groups, and also between mild traumatic, brain injury (MTBI) and severe traumatic brain injury (STBI) groups, in term of the global, the psychosocial and the neurobehavioral aspects of QOL. Twenty-three patients with MTBI, 23 patients with STBI and 31 normal control group were rated with a global measure(Quality of Life Index ; QOLI), a psychosocial measure(Sickness Impact Profile SIP), and a self-rating(Head Injury Symptom Checklist ; HISCL) and an objective symptom scales(Neurobehavioral Rating Scale ; NRS) The result were as follows : 1) Comparison with a control group showed that the brain-injured had expenenced significant impairment in QOL measured by above all scales(p<.01). 2) On QOLI of the patients with TBI, the decrement of QOL was not significantly different between MTBI and STBI groups. In these groups, the severity of impairment was highest in acfivify(involvement in own occupation) and the next was outlook in life. 3) On the data from SIP, psychosocial dysfunction was significantly greater in MTBI than STBI(p<.05), whereas physical impairment was similar in both groups of TBI. 4) The severity of subjective complaints on HISCL was significantly greater in(p<.05). Particularly MTBI patients experienced more severe distress from pain, noise sensitivity, and insomnia than STBI patients(p<.05). 5) On NRS, the severity of objective symptoms of both TBI groups was highest in somatic concern, depressed mood, and anxiety in decreasing order. MTBI groups had significandy higher scores than STBI group on the subscales of somatic concern, depressed mood, fatigue, and inaffention(p<.05). In summary, the decrement of QOL in the MTBI group was much the same as STBI groups. These data suggest that symptomatic MTBI as well as STBI patients may experience impaired QOL in a number of domain well beyond the acute post-injury phases, and that severity of injury, defined by duration of loss of consciousness and post-traumatic amnesia, and finding of neuroimaging techniques, is not apperaciable related to the QOL.

Efficacy and Safety Profile of Risperidone in Schizophrenia: Open Multicenter Clinical Trial / 신경정신의학

OBJECTIVE: The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. METHOD: This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points: at baseline, and 1,2,4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. RESULTS: 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action: a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. CONCLUSIONS: This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Quality of Life Level in the Patients with Traumatic Brain Injury / 신경정신의학

This study was designed to investigate the quality of life(QOL) In the patients with traumatic brain injury(TBI), in view of the global, psychosocial and neurobehavioral aspects of QOL. Thirty-one patients with TBI and corresponding matched controls were rated with a global measure(Quality of Life-Index, QL-Index), a psychosocial measure(Sickness Impact Profile ; SIP), and a self-rating(Head Injury Symptom Checklist: HISCL) and an objective symptom scales(Neurobehavioral Rating Scale, NRS). The results were as follows: 1) There were significant differences between the TBI and the control groups in the level of QOL measured by all scales(p<0.01). 2) On QL-Index, the decrement of QOL was 67.4+/-19.2 in TBI group, and 8.1+/-6.4 in control group. In TBI group, the severity of impairment was highest in activity(involvement in own occupation)', and the following items were 'Outlook in Life', 'Perception of own Health', 'Activities of Daily Living', and 'Support of Family and Friends' in decreasing order of severity. 3) On SIP, the degree of psychosocial dysfunction was 67.2+/-20.1 in TBI group, and 8.5 +/-6.9 in control group. In TBI group, the impairment was highest in 'Work' and the following items were 'Home Management' and 'Social Interaction', with 'Body Care and Movement' and 'Eating' the lowest. 4) On HISCL the severity of subjective symptoms of TBI patients was highest in 'Memory', and the next were 'Concentration' and 'Home sensitivity' and the lowest were 'Light sensitivity' and 'Insomnia' 5) On NRS, the severity of objective symptoms of TBI patients was highest in 'Somatic concern', 'Depressive mood', and 'Anxiety' in decreasing order. Among the flour factors of HRS, the severity of impairment was highest in Factor III (Somatic/Anxiety), and the next were Factor I(Cognition/Energy), Factor II(Metacognition), and Factor IV(Language). 6) There was significant correlation among the total scores of all the above scales in the patients with TBl(p<0.01).