ABSTRACT
OBJECTIVE: To determine the long-term outcome after severe brain injury at preschool age. DESIGN: Follow-up until adult life. SETTING: A centralized guidance center for all traffic-associated injuries. PATIENTS: Children with severe brain injury at preschool age between January 1959 and December 1969. MAIN OUTCOME MEASURE: Final evaluation in adulthood was performed by our team. The capability to work and live independently was rated. RESULTS: Twenty three (59%) of 39 children attended a typical school, eight (21%) attended a school for the physically disabled, and seven (18%) attended a school for the mentally retarded; information was not available for one child. In adulthood, nine patients (23%) were able to work full-time, 10 (26%) worked at sheltered workplaces, 14 (36%) lived independently at home, and six (15%) needed physical and/or psychotherapeutic support. The difference between normal school performance (59%) and capability to work full-time (23%) was significant (P < .05). In evaluating different aspects after the severe brain injury, the sense of identity was the best indicator of final outcome. CONCLUSIONS: The final evaluation of severe brain injury at preschool age should be performed in adulthood. Normal school performance or normal intelligence functioning is not a guarantee for good long-term prognosis. To let the child develop a firm identity is essential for good outcome.
Subject(s)
Brain Injuries/complications , Employment/statistics & numerical data , Identification, Psychological , Accidents, Traffic , Brain Injuries/psychology , Child , Child, Preschool , Developmental Disabilities/etiology , Education , Female , Follow-Up Studies , Humans , Intellectual Disability/etiology , Intelligence , Male , Prognosis , Unconsciousness/complicationsABSTRACT
Roughly 3,000 war veterans with moderate or severe brain injury have suffered from a psychiatric disturbance. Psychotic disorders are found in approximately 750 cases. The material of this preliminary report consists of the first 100 veterans with paranoid disorders. Delusional psychosis is the most common main diagnosis (28% of veterans), followed by major depression (21%), delirium (18%) and paranoid schizophrenia (14%). Paranoid schizophrenia and paranoid schizophreniform psychosis develop earlier (in 23% of cases within 1 year) than delusional psychosis (4%). Delusional psychosis lasted less than a year in 28% of the cases and more than 5 years in 40% of cases. The corresponding figures for paranoid schizophrenia and paranoid schizophreniform psychoses are 26 and 63%. Jealousy or fear of being sexually betrayed constitutes the most prominent individual content of delusions.
Subject(s)
Brain Injuries/complications , Paranoid Disorders/etiology , Veterans/psychology , Adult , Aged , Follow-Up Studies , Humans , Jealousy , Middle Aged , Paranoid Disorders/psychology , Psychotic Disorders/etiology , Psychotic Disorders/psychology , Sexual Behavior/psychologyABSTRACT
During the years 1939-1945 Finland was involved in the Second World War, divided for her part into three different wars: The Winter War, The Continuation War and The Lappish War. Finland was not occupied and she was spared wholesale bombing. The country suffered most of her casualties through the battles at the front, the majority being men born in 1886-1926. Some 700,000 men and women took part in her defence and almost half of them were wounded or killed. Finland was compelled to build up her health and medical services from scratch for the rehabilitation and care of those wounded in War. During the 1980's the geriatric problems of the war cripples have increased and many new patients are now complaining about their war wounds for the first time. The medical care of war cripples in Finland will cover 70 years; thus 20 years work remains.
