Scottish head injury rehabilitation: an historical account.

During the Second World War two units were established in Scotland for the rehabilitation of head injured patients which were ahead of their time in philosophy and practice. Despite advice to the contrary, these two facilities were not maintained in the ensuing post-war years and while other countries have expanded and improved upon the concepts of care for the traumatically brain injured no specific unit for head injury rehabilitation exists in Scotland today.

Attitudes to food, eating and weight in acutely ill and recovered anorectics.

A between-groups experimental design was used to test groups of acutely ill anorectics (n = 15), former anorectic patients who had been judged recovered at discharge (n = 14), psychiatric controls (n = 10) and normals (n = 24) on the Eating Attitudes Test (EAT). It was hypothesized that both acutely ill and recovered anorectics would show significantly greater distorted attitudes to food, eating and weight than controls, as assessed by the EAT. Results supported the hypothesis and suggest that anorectics may continue to show distorted attitudes to food, eating and weight after they have recovered from the gross physical and behavioural features of the disorder, although these attitudes appear to be somewhat less extreme than during the acute phase. It is concluded that an important aspect of anorexia nervosa appears to be largely unaltered by present treatment.

Methodological problems in assessing psychosocial recovery following severe head injury.

A number of specific methodological issues have arisen in studies of the social, emotional, and behavioural sequelae of head injury. The accounts given by patients and relatives may differ: Patients may lack insight, and relatives--who are often under considerable stress--may themselves give distorted accounts. Moreover, the sequelae of head injury may not all be specific to brain injury but may include effects common to other forms of traumatic injury: The use of control groups may help disentangle specific and non-specific effects.

Post-concussional symptoms, financial compensation and outcome of severe blunt head injury.

Two groups, each of 21 cases of severe blunt head injury, were compared. Patients in one group were pursuing claims for financial compensation while patients in the other were not. Patients were assessed on cognitive tests, and both patients and relatives were interviewed at 3, 6 and 12 months after injury. There were few differences between claimants and non-claimants: post-concussional symptoms were common in both, cognitive performance was equal, and the reports given by relatives of changes in the patients were very similar. However, the reports given by patients themselves differed with claimants reporting slightly more symptoms than non-claimants.

The short-term outcome of severe blunt head injury as reported by relatives of the injured persons.

A close relative of 55 severely head injured adults (post-traumatic amnesia greater than or equal to 2 days) was interviewed 3, 6 and 12 months after injury to obtain information about psychosocial changes in the patient. The problems most frequently reported were emotional disturbances, poor memory, and subjective symptoms, with physical disability much less common. The amount of stress experienced by relatives did not diminish between 3 and 12 months, and was related to the incidence of mental and behavioural changes in the patient. The question of whether or not compensation was being claimed did not appear to influence the outcome.