Kattula, Dheeraj (2013) A Cross-Sectional study of Neuropsychiatric problem in patients with Traumatic Brain Injury Treated in a Tertiary Care Rehabilitation Center. Masters thesis, Christian Medical College, Vellore.
|
Text
201801113kattuladheeraj.pdf Download (7MB) | Preview |
Abstract
OBJECTIVES: 1. To measure and describe the nature and prevalence of neuropsychiatric problems and psychiatric disorder after Traumatic Brain Injury (TBI). 2. To measure disability consequent to TBI. 3. To study the association if any between socio-demographic variables, trauma related variables, cognitive status, presence of psychiatric illness prior to TBI and co-morbidities with the occurrence of neuropsychiatric problems and disability. METHODS : Adult patients with TBI, who are admitted in Rehabilitation Institute who fulfil selection criteria are recruited into the study. The using standard tools neuropsychiatic symptoms, cognitive status, disability were measured. Clinical interview and review of records gave information about TBI and psychiatric disorders. Descriptive analysis of the outcomes was done. Comparison was made between different groups with appropriate statistical tools. Univariate regression analyses were performed for all associated factors. Multivariate analysis was done for factors found to be associated by adjusting for other factors. RESULTS : In the subjects under study 30% had psychiatric disorders. 94 % of them had neuropsychiatric symptoms. Operation having been performed on them increased the risk significantly by 5 times for both outcomes. Indicating more severe head injury leads to greater neuropsychiatric morbidity. Distribution of NPI scores was skewed to right. Its median was 11.5 with interquartile range from 5 to 8. Symptoms of depression, agitation/aggression and irritability/lability had high care-giver distress. Symptoms of appetite change, irritability/lability, agitation/aggression and apathy and indifference had high burden scores on the patients. Alcohol consumption at the time of injury and severity of injury measured in GCS was associated with worse level of functioning in Ranchos Los Amigos Level of Cognitive functioning scale. The same were associated with patients not assessable for cognitive function through Addenbrooke’s Cognitive Examination- Revised test. Distribution of Disability scores was skewed to right. It had a median of 7.25 with an interquartile range of 4 to 17.Presence of weakness in more than one limb was significantly associated with greater disability as measured by Disability Rating Scale. CONCLUSION : The prevalence of psychiatric disorder and neuropsychiatric symptoms in patients with traumatic brain injury admitted in the tertiary care Physical Medicine and Rehabilitation facility was very high. Needing a neurosurgery, a marker for severe injury was significantly associated with these. Presence of weakness of 2 or more limbs and consumption of alcohol at the time of injury was significantly associated with higher disability. The neuropsychiatric symptoms of agitation/aggression, irritability and weight/ appetite change were the most burdensome symptoms to patients and caregivers. Treatment of patients with TBI should involve a multidisciplinary approach, in which there is a close collaboration between neurologist/neurosurgeon, physiatrist, family physician, social worker, psychologist, family members, patient and the psychiatrist.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Neuropsychiatric Problem ; Patients ; Traumatic Brain Injury Treated ; Tertiary Care Rehabilitation Center. |
| Subjects: | MEDICAL > Psychiatry |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Aug 2017 00:54 |
| Last Modified: | 16 Aug 2017 11:54 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1880 |
Actions (login required)
 |
View Item |
