The Journal of nervous and mental disease
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J. Nerv. Ment. Dis. · Oct 1998
Posttraumatic stress symptomatology after childhood traumatic brain injury.
The purpose of this study was to quantify and to identify predictors of posttraumatic stress disorder (PTSD) symptomatology after traumatic brain injury (TBI). Fifty children aged 6 to 14 years, hospitalized after TBI, were assessed soon after TBI regarding injury severity and preinjury psychiatric, socioeconomic, family functioning, and family psychiatric history status; neuroimaging was also analyzed. Psychiatric assessments were repeated 3, 6, 12, and 24 months after TBI. ⋯ The presence of an internalizing disorder at time of injury followed by greater injury severity were the most consistent predictors of PTSD symptomatology. It is apparent, therefore, that PTSD and subsyndromal posttraumatic stress disturbances occur despite neurogenic amnesia. These problems should be treated, particularly if symptoms persist beyond 3 months.
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This report on the Chandigarh Acute Psychosis Study examines the early course of affective disorders of acute onset in a developing country setting. Forty-one cases of acute onset affective disorder (17 depressive and 24 manic subjects) were assessed at intake and evaluated at selected intervals up to 1 year. The rates of recovery and relapse and episode duration were determined for both the depressive and manic groups, and the relationship between possible predictors of outcome and the duration of the index episode was examined. ⋯ For depression and mania, respectively, the mean episode duration was 14.2 and 10.2 weeks, and the rate of relapse was 18% and 21%. Overall, these outcomes are considerably more favorable than in comparable studies of affective disorders in developed settings. Our findings suggest that acuteness of onset may be a major prognostic factor in predicting the course of affective disorders.
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J. Nerv. Ment. Dis. · Jun 1997
Traumatic brain injury in children and adolescents: psychiatric disorders in the second three months.
Psychiatric disorders may be common after traumatic brain injury (TBI) in children, yet there is a death of prospective studies examining this problem. Fifty children aged 6 to 14, hospitalized after TBI, were assessed soon after TBI regarding preinjury psychiatric, behavioral, adaptive, and family functioning, family psychiatric history status and injury severity. The outcome measure was the presence of a "novel" psychiatric disorder (not present before the injury) during the second 3 months after the injury. ⋯ Severity of injury, family psychiatric history, and family function predicted a novel psychiatric disorder. Among children suffering a mild/moderate injury, those with preinjury lifetime psychiatric disorders were no longer (as they had been in the first 3 months) at higher risk than those without such a lifetime history. Thus, there appeared to be children, identifiable through clinical assessment, at increased risk for novel psychiatric disorders after TBI.
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J. Nerv. Ment. Dis. · Oct 1996
On the interaction of hypnotizability and negative affect in chronic pain. Implications for the somatization of trauma.
The high risk model of threat perception predicts that high hypnotizability is a risk factor for trauma-related somatization. It is hypothesized that high hypnotizability can increase experimentally induced threat or negative affect, as measured by skin conductance level, in a linear or dose-response manner. ⋯ In addition, individuals with high hypnotizability retained higher skin conductance levels than individuals with low hypnotizability after stress. The clinical implications of the interaction of hypnotizability and negative affect during threat perception and delayed recovery from threat perception are discussed in terms of cognitive mechanisms in the etiology and therapy of trauma-related dissociative disorders.