대한불안의학회지 (Anxiety and mood)

  • 제8권1호
  • /
  • Pages.31-40
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  • 2012
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  • 2586-0151(pISSN)
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  • 2586-0046(eISSN)
대한불안의학회 (Korean Academy of Anxiety Disorders)
권호 표지

두부외상 환자에서 전두엽 손상과 신경인지기능 변화에 따른 주관적인 증상 연구

The Study of the Subjective Symptoms according to Frontal Lobe Damage and Change in Neurocognitive Function in Traumatic Head Injury Patients

  • 김준원 (국립공주병원 정신건강의학과) ;
  • 한덕현 (중앙대학교 의과대학 정신건강의학교실) ;
  • 기백석 (중앙대학교 의과대학 정신건강의학교실) ;
  • 박두병 (중앙대학교 의과대학 정신건강의학교실)
  • Kim, Jun-Won (Department of Psychiatry, Gongju National Hospital) ;
  • Han, Doug-Hyun (Department of Psychiatry, College of Medicine, Chung-Ang University) ;
  • Kee, Baik-Seok (Department of Psychiatry, College of Medicine, Chung-Ang University) ;
  • Park, Doo-Byung (Department of Psychiatry, College of Medicine, Chung-Ang University)
  • 투고 : 2012.02.24
  • 심사 : 2012.03.30
  • 발행 : 2012.04.30
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초록

Objective : The purpose of this study was to analyze the correlation between symptom severity and neurocognitive factors in traumatic head injury patients. In addition, the effect of frontal lobe damage on these parameters was examined. Methods : We selected 18 patients who had brain damage for the moderate to severe traumatic brain injury (MSTBI) group, and 17 patients who met the diagnostic criteria for post-traumatic stress disorder (PTSD) without the finding of brain damage for the comparison group. For the evaluation of neurocognitive function, K-WAIS, Rey-Kim Memory Test, K-FENT, WCST, and MMPI-2 were used. Results : The results of the comparison (using the malingering scale) revealed that the values of PDS and PK, which express the severity of symptoms, and the values of the validity scale F, F (B), and F (P) were significantly higher in the overly-expressed group. F (B) in overly-expressed group and PK, Pt, and Sc in the properly-expressed group had significant correlation with the severity of symptoms. F (B), S, and Stroop error inhibition in PTSD, and PK, Pt, Sc, and MQ in MSTBI had significant correlation with the severity of symptoms. The results of the comparison based on the finding of frontal lobe damage revealed that PDS, EIQ, and MQ ware significantly higher in the group without brain damage. Conclusions : It was revealed that each neurocognitive factor was correlated with the severity of symptoms. There was a decrease in complaints or symptoms reported by the frontal lobe injury group, and this is believed to be due to degenerative change in the personality and emotional functioning of these patients following frontal lobe damage.

키워드

참고문헌

  1. Schutze M, Kundt G, Buchholz K, Piek J. Which factors are predictive for long-term complaints after mild traumatic brain injuries?. Versicherungsmedizin 2008;60:78-83.
  2. Beckham JC, Crawford AL, Feldman ME. Trail making test performance in Vietnam combat veterans with and without posttraumatic stress disorder. J Traumatic Stress 1998;11:811-819. https://doi.org/10.1023/A:1024409903617
  3. Binder LM, Rohling ML. Money matters: a meta-analytic review of the effects of financial incentives on recovery after closed-head injury. Am J Psychiatry 1996;153:7-10. https://doi.org/10.1176/ajp.153.1.7
  4. Shin L, Rauch S, Pitman R. Amygdala, medial prefrontal cortex, and hippocampal function in PTSD. Ann N Y Acad Sci 2006;1071:67-79. https://doi.org/10.1196/annals.1364.007
  5. McBride ED. Disability evaluation and rating. Ins. Counsel J 1968; 35:129.
  6. Foa EB, Davidson JRT, Frances AE, Culpepper LE, Ross RE, Ross DE. The expert consensus guideline series: Treatment of posttraumatic stress disorder. J Clin Psychiatry 1999;60:1-8.
  7. Qin S, Hermans EJ, van Marle HJF, Luo J, Fernandez G. Acute psychological stress reduces working memory-related activity in the dorsolateral prefrontal cortex. Biol Psychiatry 2009;66:25-32. https://doi.org/10.1016/j.biopsych.2009.03.006
  8. Stein MB, Kennedy CM, Twamley EW. Neuropsychological function in female victims of intimate partner violence with and without posttraumatic stress disorder. Biol Psychiatry 2002;52:1079-1088. https://doi.org/10.1016/S0006-3223(02)01414-2
  9. Jenkins MA, Langlais PJ, Delis D, Cohen RA. Attentional dysfunction associated with posttraumatic stress disorder among rape survivors. Clin Neuropsychol 2000;25:7-12.
  10. Williams DH, Levin HS, Eisenberg HM. Mild head injury classification. Neurosurgery 1990;27:422-428. https://doi.org/10.1227/00006123-199009000-00014
  11. Khan MA, Briones DF, Brower RD, Briones M. Disability from "Soft" neuropsychiatric sequelae due to frontal lobe injury. South Med J 2009;102:829-831. https://doi.org/10.1097/SMJ.0b013e3181aba321
  12. Emilien G, Waltregny A. Traumatic brain injury, cognitive and emotional dysfunction. Impact of clinical neuropsychology research. Acta Neurol Belg 1996;96:89-101.
  13. Leininger BE, Kreutzer JS, Hilla MR. Comparison of minor and severe head injury emotional sequelae using the MMPI. Brain Inj 1991;5:199-205. https://doi.org/10.3109/02699059109008090
  14. Koren D, Norman D, Cohen A, Berman J, Klein EM. Increased PTSD risk with combat-related injury: a matched comparison study of injured and uninjured soldiers experiencing the same combat events. Am J Psychiatry 2005;162:276-282. https://doi.org/10.1176/appi.ajp.162.2.276
  15. Norris AE, Aroian KJ. Assessing reliability and validity of the Arabic language version of the Post-traumatic Diagnostic Scale (PDS) symptom items. Psychiatry Res 2008;160:327-334. https://doi.org/10.1016/j.psychres.2007.09.005
  16. Wolf EJ, Miller MW, Orazem RJ, Weierich MR, Castillo DT, Milford J, et al. The MMPI-2 restructured clinical scales in the assessment of posttraumatic stress disorder and comorbid disorders. Psychol Assess 2008;20:327-340. https://doi.org/10.1037/a0012948
  17. Dean AC, Boone KB, Kim MS, Curiel AR, Martin DJ, Victor TL, et al. Examination of the impact of ethnicity on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Fake Bad Scale. Clin Neuropsychol 2008;22:1054-1060. https://doi.org/10.1080/13854040701750891
  18. Foa EB, Cashman L, Jaycox L, Perry K. The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale. Psychol Assess 1997;9:445-451. https://doi.org/10.1037/1040-3590.9.4.445
  19. Greiffenstein MF, Baker WJ. Validity testing in dually diagnosed post-traumatic stress disorder and mild closed head injury. Clin Neuropsychol 2008;22:565-582. https://doi.org/10.1080/13854040701377810
  20. Yum TH, Park YS, Oh KJ, Lee YH. The manualof Korean-Wechsler adult intelligence scale. Seoul: Korean Guidance Press;1992.
  21. Kim H. Rey-Kim memory test. Daegu: Korea Neuropsychology Press;1999.
  22. Kim H. Kims Frontal-Executive Function Neuropsychological Test: Manual. Daegu: Korea Neuropsychology Press;2001.
  23. Forbes D, Creamer M, Allen N, Elliott P, McHugh T, Debenham P, et al. MMPI-2 based subgroups of veterans with combat-related PTSD: differential patterns of symptom change after treatment. J Nerv Ment dis 2003;191:531-537. https://doi.org/10.1097/01.nmd.0000082181.79051.83
  24. Elhai JD, Gold PB, Frueh BC, Gold SN. Cross-validation of the MM-PI-2 in detecting malingered posttraumatic stress disorder. J Pers Assess 2000;75:449-463. https://doi.org/10.1207/S15327752JPA7503_06
  25. Adkins JW, Weathers FW, McDevitt-Murphy M, Daniels JB. Psychometric properties of seven self-report measures of posttraumatic stress disorder in college students with mixed civilian trauma exposure. J Anxiety Disord 2008;22:1393-1402. https://doi.org/10.1016/j.janxdis.2008.02.002
  26. Hamner MB, Frueh BC, Ulmer HG, Huber MG, Twomey TJ, Tyson C, et al. Psychotic features in chronic posttraumatic stress disorder and schizophrenia: comparative severity. J Nerv Ment Dis 2000;188:217-221. https://doi.org/10.1097/00005053-200004000-00004
  27. Bryant RA. Posttraumatic stress disorder and traumatic brain injury: can they co-exist? Clin Psychol Rev 2001;21:931-948. https://doi.org/10.1016/S0272-7358(00)00074-X
  28. Buodo G, Ghisi M, Novara C, Scozzari S, Di Natale A, Sanavio E, et al. Assessment of cognitive functions in individuals with post-traumatic symptoms after work-related accidents. J Anxiety Disord 2011; 25:64-70. https://doi.org/10.1016/j.janxdis.2010.08.004
  29. Park KC, Kim HJ. Psychosocial outcome after head injury. J Korean Neurosurg Soc 2000;29:196-202.
  30. Saltzman KM, Weems CF, Carrion VG. IQ and posttraumatic stress symptoms in children exposed to interpersonal violence. Child Psychiatry Hum Dev 2006;36:261-272. https://doi.org/10.1007/s10578-005-0002-5
  31. Kuhajda MC, Thorn BE, Klinger MR, Rubin NJ. The effect of headache pain on attention (encoding) and memory (recognition). Pain 2002;97:213-221. https://doi.org/10.1016/S0304-3959(01)00488-2
  32. Koo BH, Bai DS. The comparison of psychiatric symptoms in traumatic head injury with and without intelligence and memory impairments. J Korean Soc Biol Ther Psychiatry 2006;12:182-195.
  33. Ju D, Varney NR. Can head injury patients simulate malingering? Appl Neuropsychol 2000;7:201-207. https://doi.org/10.1207/S15324826AN0704_1
  34. Rommel O, Widdig W, Mehrtens S, Tegenthoff M, Malin JP. Frontal lobe syndrome caused by severe head trauma or cerebrovascular diseases. Nervenarzt 1999;70:530-538. https://doi.org/10.1007/s001150050476
  35. Oddy M, Coughlan T, Tyerman A, Jenkins D. Social adjustment after closed head injury: a further follow-up seven years after injury. J Neurology Neurosurg Psychiatry 1985;48:564-568. https://doi.org/10.1136/jnnp.48.6.564