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.

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).