두부손상 환자에서 뇌손상 부위에 따른 우울증상 및 인지장애에 관한 연구

A Clinical Study of Depressive Symptoms and Cognitive Impairments According to Lesion Site in Patients with Head Trauma

This study was designed to evaluate the relationship between psychiatric symptoms(depressive symptoms and cognitive impairments) and cerebral lesion site in psychiatric inpatients with history of head trauma by traffic accident Subjects were 71 psychiatric inpatients with history of head trauma who were admitted to the department of psychiatry of Chonbuk National University Hospital from February 1989 to June 1991. Patients were divided into three groups according to lesion sites : patients with left hemispheric lesion (LHL, N = 2l), patients with right hemispheric lesion(RHL, N = 2 l) and patients with no definite lesion (NDL, N=29). Psychiatric symptoms including depressive symptoms and cognitive impairments were examined by Hamilton Rating Scale for Depression(HRSD), Minnesota Multiphasic Personality Inventory (MMPI), Mini-Mental Status Examination(MMSE) and Korean Wechsler Intelligence Scale(KWIS). Cerebral lesion sites were detected by Brain CT scan. The results were as follows : 1) Patients with left hemispheric lesion showed higher HRSD scores than patients with other lesion sites. 2) Patients with left anterior lesion showed higher HRSD than patients with other lesion sites. 3) There were no different findings in MMPI profiles compared with preexisting reports. But our results suggested that patients with left hemispheric lesion primarily showed mood disturbances and patients with right hemispheric lesion primarily showed thought disorders. 4) There were no significant differences among three groups in MMSE scores. However, memory, construction, attention and calculation seemed to be affected more than orientation and language in all of the groups. 5) There were no significant differences among three groups in KWIS scores, but there was a trend that performance IQ was lower than verbal IQ in all of the three groups.