Trauma- and distress-associated mental illness symptoms in close relatives of patients with severe traumatic brain injury and high-grade subarachnoid hemorrhage

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• 作者：Stefan Mark Rueckriegel ; Marianne Baron ; Katharina Domschke…
• 关键词：Subarachnoid hemorrhage ; Traumatic brain injury ; Post ; traumatic stress disorder ; Anxiety symptoms ; Depression symptoms ; Intensive care unit
• 刊名：Acta Neurochirurgica
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：157
• 期：8
• 页码：1329-1336
• 全文大小：412 KB
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• 作者单位：Stefan Mark Rueckriegel (1)
  Marianne Baron (1)
  Katharina Domschke (2)
  Silke Neuderth (3)
  Ekkehard Kunze (1)
  Almuth Friederike Kessler (1)
  Robert Nickl (1)
  Thomas Westermaier (1)
  Ralf-Ingo Ernestus (1)
  
  1. Department of Neurosurgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
  2. Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Fuechsleinstrasse 15, 97080, Wuerzburg, Germany
  3. Department of Medical Psychology, Psychotherapy and Rehabilitation Sciences, Julius-Maximilians-University Wuerzburg, Klinikstrasse 3, 97070, Wuerzburg, Germany
  
• 刊物主题：Neurosurgery; Interventional Radiology; Neuroradiology; Neurology; Surgical Orthopedics; Minimally Invasive Surgery;
• 出版者：Springer Vienna
• ISSN：0942-0940

文摘

Background Close relatives (CR) of patients with severe traumatic brain injury (TBI) and high-grade subarachnoid hemorrhage (SAH) suffer extraordinary distress during the treatment: Distress may lead to persisting mental illness symptoms within the spectrum of post-traumatic stress disorder (PTSD), anxiety disorders, and depression. The primary goal of this study was to determine the prevalence and severity of these symptoms in CR. The secondary goal was identification of associated factors. Method Standardized interviews were conducted with 53 CR (mean age of 57.7?±-1.4?years) of patients with TBI °III (n--7) and high-grade SAH H&H °III–V (n--6) between 5 and 15?months after the event. The interviews contained a battery of surveys to quantify symptoms of PTSD, anxiety disorders, and depression, i.e., Impact of Event Scale (IES-R), 36-item Short-Form General Health Survey (SF-36), and Hospital Anxiety and Depression Scale (HADS). Fixed and modifiable possibly influencing factors were correlated. Results Twenty-eight CR (53?%) showed IES-R scores indicating a probable diagnosis of PTSD. Twenty-five CR (47?%) showed an increased anxiety score and 18 (34?%) an increased depression score using HADS. Mean physical component summary of SF-36 was not abnormal (49.1?±-.1), whereas mean mental component summary was under average (41.0?±-3.2), indicating a decreased quality of life caused by mental effects. Perception of the interaction quality with the medical staff and involvement into medical decisions correlated negatively with severity of mental illness symptoms. Evasive coping strategies were highly significantly associated with symptoms. Conclusions This study quantifies an extraordinarily high prevalence of mental illness symptoms in CR of patients with critical acquired brain injury due to SAH and TBI. Modifiable factors were associated with severity of mental illness symptoms. Prospective studies testing efficiency of early psychotherapeutic interventions are needed.