두뇌손상환자의 정신장애평가 기준설정을 위한 연구 - 2 . 정신병리와 진단一

Study for the Establishment of Mental Disability Evaluation Criteria in Head Injuries — 2. Psychopathology and Diagnosis —

The psychopathology and subjective physical symptoms were studied in 95 head injury patients. Memory impairment, concentration difficulty, and nervousness and irritability were the most frequent triad of mental symptoms. Among subjective physical symptoms the headache, head-conscious, and fatigability were the most frequent ones. 53.7 % of the patients were diagnosed as postconcussional syndrome, 20.0 % as organic personality syndrome, 13.7 % as dementia, 9.5% as neurosis or posttraumatic stress disorders and 3.2% as organic amnestic syndrome. Cognitive impairments and behavioral disorders were significantly helpful in differentiating post-traumatic conditions, but the affective disorders and somatic symptoms were not. The symptom constellations of postconcussional syndrome seems to be present in all head injuries. The cluster analysis of postconcussional syndrome revealed 4 main divisions, the pure postconcussional syndrome, postconcussional neurotic state, postconcussional syndrome with personality change and postconcussional syndrome with cognitive impairment. Long-term follow up observations and study for the patients whose financial compensation were not an issue are necessary for an objective evaluation of head injuries.