Journal of the Korean Academy of Child and Adolescent Psychiatry
- Volume 10 Issue 2
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- Pages.212-219
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- 1999
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- 2233-9183(eISSN)
NEUROPSYCHIATRIC SEQUELAE AND ITS EVALUATION IN CHILDREN AND ADOLESCENTS WITH TRAUMATIC BRAIN INJURY
외상성 뇌손상 아동의 신경정신과적 후유증 평가
- Kim, Hae-Gyoung (Department of Psychiatry, Wonju College of Medicine, Yonsei University) ;
- Bhang, Hyung-Suk (Department of Psychiatry, Wonju College of Medicine, Yonsei University) ;
- Park, Gwang-Soo (Department of Psychiatry, Wonju College of Medicine, Yonsei University) ;
- Wang, Mi-Rhan (Department of Psychiatry, Wonju College of Medicine, Yonsei University) ;
- Min, Seong-Ho (Department of Psychiatry, Wonju College of Medicine, Yonsei University) ;
- Park, Ki-Chang (Department of Psychiatry, Wonju College of Medicine, Yonsei University) ;
- Ahn, Joung-Sook (Department of Psychiatry, Wonju College of Medicine, Yonsei University)
- 김혜경 (연세대학교 원주의과대학 정신과학교실) ;
- 방형석 (연세대학교 원주의과대학 정신과학교실) ;
- 박광수 (연세대학교 원주의과대학 정신과학교실) ;
- 왕미란 (연세대학교 원주의과대학 정신과학교실) ;
- 민성호 (연세대학교 원주의과대학 정신과학교실) ;
- 박기창 (연세대학교 원주의과대학 정신과학교실) ;
- 안정숙 (연세대학교 원주의과대학 정신과학교실)
- Published : 1999.12.31
Abstract
Objective:This study is designed to get clinical guidelines for management of children with TBI by examining neuropsychiatric sequelae of TBI, determining whether the severity of TBI, type of treatment, and enviornmental factors are related to those sequelae, and defining the adequacy of public psychological tests as evaluating tools for them. Method:This is chart review of 47 children, aged 5 to 14 years, referred to a psychiatric outpatient clinic for neuropsychiatric evaluation at least 6 months after TBI. Data on the initial GCS score, associated injury, treatment type, and duration of hospital stay are obtained from medical records. EEG, MRI, intelligent test, and several psychological tests are administrated at the point of assessment. Results:1) Cognitive symptoms outnumber externalizing behavioral, emotional, and somatic symptoms, with no significant differences of frequencies of those 4 categorical symptoms between mild injury group and moderate to severe group. 2) Children treated with non-surgical method(p<0.01) complain more cognitive symptoms than the others. 3) Behavioral symptoms are related to younger age(p<0.05), and to anticonvulsant medication(p<0.05). 4) Children with associated injury complain emotional symptoms more frequently(p<0.05). 5) More somatic symptoms are presented by children with no medication(p<0.05), and with higher I.Q(p<0.05). 6) Low I.Q is correlated to low GCS score (p<0.05). Cognitive impairment is confirmed in 25 in 42 children complaining cognitive symptoms though I.Q test and BGT, whose hospital stay is longer than the others(p<0.05). 7) emotional disturbance is confirmed in 22 in 25 children showing emotional problems through psychological tests, who complain cognitive symptoms more frequently(p<0.05). Conclusion:This findings suggest that even mild TBI children need to be followed-up and treated as complaining neuropsychiatric symptoms over 6 months after injury, and shorter hospital stay is recommended for cognitive and emotional status of children, and for better evaluation of neuropsychiatric sequelae of TBI, more specific tests should be included in neuropsychological test tools.
본 연구는 뇌손상 아동의 후유증을 조사하고, 이 증상에 손상요인, 치료요인, 환경요인이 관련되어 있는 지와, 후유증을 평가하는데 일반적인 심리검사가 적절한지를 규명함으로써 뇌손상 아동의 후유증 치료, 예방 및 평가에 관한 임상적 지침을 얻고자하였다. 연세대학교 원주기독병원 응급의학과와 신경외과에서 뇌손상에 관한 치료를 받고 최소한 6개월이 지난 후 정신과에 신경정신과적 평가가 의뢰된 47명의 아동(연령