scholarly journals Cognitive Impairment after Severe Traumatic Brain Injury, Clinical Course and Impact on Outcome: A Swedish-Icelandic Study

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Maud Stenberg ◽  
Alison K. Godbolt ◽  
Catharina Nygren De Boussard ◽  
Richard Levi ◽  
Britt-Marie Stålnacke

Objective. To assess the clinical course of cognitive and emotional impairments in patients with severe TBI (sTBI) from 3 weeks to 1 year after trauma and to study associations with outcomes at 1 year.Methods. Prospective, multicenter, observational study of sTBI in Sweden and Iceland. Patients aged 18–65 years with acute Glasgow Coma Scale 3–8 were assessed with the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) and the Hospital Anxiety and Depression Scale (HADS). Outcome measures were Glasgow Outcome Scale Extended (GOSE) and Rancho Los Amigos Cognitive Scale-Revised (RLAS-R).Results. Cognition was assessed with the BNIS assessed for 42 patients out of 100 at 3 weeks, 75 patients at 3 months, and 78 patients at 1 year. Cognition improved over time, especially from 3 weeks to 3 months. The BNIS subscales “orientation” and “visuospatial and visual problem solving” were associated with the GOSE and RLAS-R at 1 year.Conclusion. Cognition seemed to improve over time after sTBI and appeared to be rather stable from 3 months to 1 year. Since cognitive function was associated with outcomes, these results indicate that early screening of cognitive function could be of importance for rehabilitation planning in a clinical setting.

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Britt-Marie Stålnacke ◽  
Britt-Inger Saveman ◽  
Maud Stenberg

Aim. To assess the clinical course of disability, cognitive, and emotional impairments in patients with severe TBI (s-TBI) from 3 months to up to 7 years post trauma.Methods. A prospective cohort study of s-TBI in northern Sweden was conducted. Patients aged 18-65 years with acute Glasgow Coma Scale 3-8 were assessed with the Glasgow Outcome Scale Extended (GOSE), the Hospital Anxiety and Depression Scale (HADS), and the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) at 3 months, 1 year, and 7 years after the injury.Results. The scores on both GOSE and BNIS improved significantly from 3 months (GOSE mean:4.4±2.3, BNIS mean:31.5±7.0) to 1 year (GOSE mean:5.5±2.7,p=0.003, BNIS mean:33.2±6.3,p=0.04), but no significant improvement was found from 1 year to 7 years (GOSE mean:4.7±2.8,p=0.13, BNIS mean:33.5±3.9,p=0.424) after the injury. The BNIS subscale “speech/language” at 1 year was significantly associated with favourable outcomes on the GOSE at 7 years (OR=2.115, CI: 1.004-4.456,p=0.049).Conclusions. These findings indicate that disability and cognition seem to improve over time after s-TBI and appear to be relatively stable from 1 year to 7 years. Since cognitive function on some of the BNIS subscales was associated with outcome on the GOSE, these results indicate that both screening and follow-up of cognitive function could be of importance for the rehabilitation of persons with s-TBI.


2013 ◽  
Vol 13 (2) ◽  
pp. 115-123 ◽  
Author(s):  
Cristiane Decat Bergerot ◽  
Karen Lynn Clark ◽  
Alexandre Nonino ◽  
Sarah Waliany ◽  
Marco Murilo Buso ◽  
...  

AbstractObjective:The aim of our study was to explore the impact of gender and hematological cancer grade on distress, anxiety, and depression in patients receiving chemotherapy.Methods:A prospective study was done in a cohort of 104 patients with hematological cancer. We employed the (1) Distress Thermometer (DT) and the Problem List (PL) and (2) the Hospital Anxiety and Depression Scale (HADS) for assessments at baseline (T1), the halfway timepoint (T2), and completion of chemotherapy (T3).Results:The proportion of patients experiencing significant distress (DT ≥ 4) decreased from the first to the last timepoint; the proportion experiencing anxiety and depression (as assessed by HADS) also decreased. Specifically, 50% of participants reported significant distress levels, 47.1% anxiety, and 26% depression at T1. At T2, the proportion of patients experiencing distress was reduced by 60.8%, by 76% for anxiety, and by 48.5% for depression; at T3, the reduction was close to 80% for all assessments compared with T1. Emotional and physical problems were most commonly reported. Significant reductions were discovered for distress and problem-related distress levels over time, and a significant interaction was found between gender and practical and physical problems (p < 0.05).Significance of results:Our findings suggest that female patients reported more distress, anxiety, and depression than male patients. Gender differences were related to problem-related distress but not to grade of neoplasm. We observed that, over the course of chemotherapy, the distress levels of patients with hematological cancer decrease over time.


2017 ◽  
Vol 13 (3) ◽  
pp. 121-128
Author(s):  
Carlotta Defferrari ◽  
Cristina Barbara ◽  
Matteo Puntoni ◽  
Marilena Petrera ◽  
Stefano Domenicucci ◽  
...  

Introduction: Attempts to quit smoking have increased in recent years, but the patterns of variations over time are unknown. We aimed at describing time- and sex-related changes in a population of 2,231 subjects who adhered to a smoking-cessation programme lasting 13 years in Italy.Methods: We measured baseline expired carbon monoxide (expired-CO), Fagerstrom nicotine dependence, Q-MAT test, Zung depression and anxiety scale, Hospital anxiety and depression scale (HADS).Results: Study population included 1,278 men and 953 women who smoked a median of 25 (interquartile range, IQR: 20–32) and 20 (IQR: 20–30) cigarettes/day, respectively (p < 0.001). The proportion of female smokers increased from 37.5% in 2001–2003 to 46.9% in 2010–2013 (p = 0.003). There was a significant time-related reduction of median daily cigarette consumption, with a more noticeable decrease in men. Median expired-CO (parts per million (ppm)) increased only in women, from 18 (IQR: 14–23) in 2001–03 to 20 (IQR: 14–28) in 2010–13 (p = 0.001), whereas Fagerstrom test for nicotine dependence did not vary. Differences in psychological characteristics in the last 3 years showed that women were more clinically depressed than men (16.6% versus 7.6%, p < 0.001).Conclusions: Despite a decrease in the number of daily cigarettes with time, expired-CO tends to increase in women, who are also more clinically depressed and anxious than men. A personalised approach to specific subgroups of smokers, with special emphasis on a psychological support for women, seems appropriate.


2009 ◽  
Vol 57 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Lena Schirmer ◽  
Anja Mehnert ◽  
Angela Scherwath ◽  
Barbara Schleimer ◽  
Frank Schulz-Kindermann ◽  
...  

Die in mehreren Studien gefundenen kognitiven Störungen bei Tumorpatienten nach Chemotherapie werden zumeist mit der Zytostatikaneurotoxizität assoziiert. In der vorliegenden Arbeit wird der Zusammenhang von Angst, Depression und Posttraumatischer Belastungsstörung mit der kognitiven Leistungsfähigkeit bei Frauen mit Mammakarzinom untersucht. Insgesamt wurden 76 Brustkrebspatientinnen fünf Jahre nach Abschluss der onkologischen Behandlung mit neuropsychologischen Testverfahren sowie mit der Hospital Anxiety and Depression Scale – Deutsche Version (HADS-D) und der Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C) untersucht: 23 nach Standard- und 24 nach Hochdosistherapie sowie 29 nach Brustoperation und Strahlentherapie als Vergleichsgruppe. Signifikante Zusammenhänge sind vor allem zwischen kognitiven Funktionen und Intrusionssymptomen einer Posttraumatischen Belastungsstörung (PTBS) festzustellen. Bei Patientinnen nach Standardtherapie weisen Intrusionen der PTBS einen moderaten Zusammenhang mit der globalen kognitiven Beeinträchtigung auf. Die Ergebnisse der Studie deuten auf multidimensionale Einfluss- und moderierende Faktoren bei der Entwicklung kognitiver Defizite bei Brustkrebspatientinnen nach onkologischer Therapie hin.


Diagnostica ◽  
2003 ◽  
Vol 49 (1) ◽  
pp. 34-42 ◽  
Author(s):  
Andreas Hinz ◽  
Winfried Rief ◽  
Elmar Brähler

Zusammenfassung. Der Whiteley-Index ist ein Instrument zur Erfassung von Hypochondrie. Für diesen Fragebogen wurde eine Normierungs- und Validierungsstudie anhand einer bevölkerungsrepräsentativen Stichprobe (n = 1996) durchgeführt. Hypochondrie zeigt eine etwa lineare Altersabhängigkeit (r = .24). Frauen haben in allen Altersstufen höhere Hypochondrie-Ausprägungen als Männer. Für verschiedene Alters- und Geschlechtsgruppen werden Normwerte bereit gestellt. Die in der Literatur beschriebene dreidimensionale Struktur des Whiteley-Index (Krankheitsängste, somatische Beschwerden und Krankheitsüberzeugung) konnte mit gewissen Einschränkungen bestätigt werden. Validierungsuntersuchungen mit anderen Instrumenten (Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Gießener Beschwerdebogen, Screening für Somatoforme Störungen und Nottingham Health Profile) zeigten, dass eine auf sieben Items reduzierte Kurzskala der Gesamtskala mit 14 Items ebenbürtig ist. Für differenzierte Analysen wird jedoch die Originalskala empfohlen. Durch die angegebenen Normwerte ist es künftig besser möglich, Patientengruppen verschiedener Alters- und Geschlechtsverteilungen untereinander oder auch mit Stichproben der Normalbevölkerung zu vergleichen.


2020 ◽  
Author(s):  
Anne Vinggaard Christensen ◽  
Jane K. Dixon ◽  
Knud Juel ◽  
Ola Ekholm ◽  
Trine Bernholdt Rasmussen ◽  
...  

2018 ◽  
Vol 9 (2) ◽  
pp. 63
Author(s):  
Anil Kumar Roy ◽  
Nilesh Maruti Gujar ◽  
Arif Ali ◽  
Utpal Borah

Background: Studies have shown that caregivers of the persons with the neurological illness have high levels of psychological distress, depression and caregiver’s burden. The aim of the study was to find out anxiety, depression and caregiver’s burden among the caregivers of persons with neurological illness (PWNI). Method: Thirty caregivers of PWNI attending the Centre of Rehabilitation Sciences, LGB Regional Institute of Mental Health, Tezpur, Assam were selected using purposive sampling technique for the present study. Socio-demographic and clinical data sheet, Zarit Burden Interview Scale and The Hospital Anxiety and Depression Scale were used. Results: The results shown that in Hospital Anxiety and Depression Scale, 26.6% of the caregivers' scores were in the abnormal range in the domain of depression. While in the domain of anxiety, 16.6% scored in the abnormal range. In Zarit Burden of Scale, 13.3% of the caregivers were having little or no burden, 26.6% of the caregivers were having mild to moderate level of burden, 20% were having moderate to severe burden and 30% were having a severe burden of care. Care burden has significant positive correlation with depression (r= .124, p≤ 0.01 and anxiety (r= .124, p≤ 0.05). Conclusion: Caregivers of PWNI have been found to be at higher risk of mental health problems and care burden. The importance of addressing the burden of caregivers involved in the care of PWNI need to be taken into consideration while providing treatment and rehabilitation of PWNI.     Keywords: Anxiety, depression, burden, neurological illness


2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Magnus Johansson ◽  
Markus Jansson-Fröjmark ◽  
Annika Norell-Clarke ◽  
Steven J. Linton

Abstract Background The aim of this investigation was to examine the longitudinal association between change in insomnia status and the development of anxiety and depression in the general population. Methods A survey was mailed to 5000 randomly selected individuals (aged 18–70 years) in two Swedish counties. After 6 months, a follow-up survey was sent to those (n = 2333) who answered the first questionnaire. The follow-up survey was completed by 1887 individuals (80.9%). The survey consisted of questions indexing insomnia symptomatology, socio-demographic parameters, and the Hospital Anxiety and Depression Scale. Change in insomnia status was assessed by determining insomnia at the two time-points and then calculating a change index reflecting incidence (from non-insomnia to insomnia), remission (from insomnia to non-insomnia), or status quo (no change). Multivariate binary logistic regression analyses were used to examine the aim. Results Incident insomnia was significantly associated with an increased risk for the development of new cases of both anxiety (OR = 0.32, p < .05) and depression (OR = 0.43, p < .05) 6 months later. Incident insomnia emerged also as significantly associated with an elevated risk for the persistence of depression (OR = 0.30, p < .05), but not for anxiety. Conclusions This study extends previous research in that incidence in insomnia was shown to independently increase the risk for the development of anxiety and depression as well as for the maintenance of depression. The findings imply that insomnia may be viewed as a dynamic risk factor for anxiety and depression, which might have implications for preventative work.


Sign in / Sign up

Export Citation Format

Share Document