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Journal of the Korean Society of Traumatology 2002;15(1):49-57.
Emergency Department Evaluation of Neuropsychiatric Complication foll owing Traumatic Injuries
Chang Hyun Kim, M.D., Hyuk Jun Yang, M.D., Gun Lee, M.D., Yong Su Lim, M.D., and Sung Youl Hyun, M.D.
Department of Emergency Medicine, Gil Medical Center, Gachon Medical School, Incheon, Korea
외상 후 발생한 신경 정신과적 합병증에 대한 고찰
김창현·양혁준·임용수·이근·현성열
가천의과대학교 길병원 응급의학과
Abstract
Background : Recent studies have suggested that patients with traumatic injuries and neuropsychiatric complications following a traumatic accident can be admitted from the emergency department. Thus, this study was designed to assess the natural course of post-traumatic symptoms formation, as well as the diagnosis and treatments. Methods : We reviewed the cases of patients (n=3906) with traumatic injuries who had been admitted in to Ghil Hospital from Jan. 1, 2000, to June 31, 2001. Among these patients, we only elaborated the 29 patients who had neuropsychiatric complication, but who had never had a history of psychopathy. Result : Twenty-nine patients were studied with a mean age of 42, and the ratio of male and females was 11 to 18. The most common causes of injuries were traffic accidents (72%), assaults (14%) and falls (14%). Patient had clinical symptoms of headaches (64%), vomiting and nausea (11%), chest pain (8%), extremity pain (6%), lower back pain (8%), and abdominal pain (3%). Exposure to traumatic events could often explain the pressure of nonspecific symptoms, such as difficulty concentrating (23%), restricted range of emotions or a feeling of numbness (23%). anxiety (27%), and nightmares and difficulty falling or staying asleep (27%). Twenty-nine patients had psychiatric complication, such as post-traumatic stress disorder (29%), depression (23%), post-concussion syndome (16%),acute stress disorder (6%), insomnia (6%),organic mental disorder (6%), and panic disorder (4%). antianxiety drug (41%), antidepressant drugs (30%), antidepressant and antipsychotic drugsAfter consultation with the neuropsychatric department, treatments were antidepressants and (7%), and antianxiety and antipsychotic drug (4%), antipsychotic drugs (7%) observation (7%), and supportive counseling (4%). Conclusion : This study showed that patients exposed to traumatic injuries, neguined a variety of psychiatric complications and required psychiatric treatments. Thus, we suggest that psychiatric complications are a concern should be a concern after traumatic injures.
Key Words: Neuropsychiatric complication; Trauma
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