青少年大脑认知发展(ABCD)研究第一年的轻度创伤性脑损伤和精神障碍。

IF 3.3 4区 医学 Q2 CLINICAL NEUROLOGY
Emily A Troyer, Wenjing Meng, Michael Cheng, Everett L Delfel, Florin Vaida, Xia Yang, Joanna Jacobus, Emily L Dennis, Elisabeth A Wilde, Tracy Abildskov, John R Hesselink, Erin D Bigler, Jeffrey E Max
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引用次数: 0

摘要

目的:小儿轻度外伤性脑损伤(mTBI)是一个重要的公共卫生问题。mTBI后可能出现新的精神疾病(npd),但非临床样本的损伤后npd仍然知之甚少。方法:对参加青少年大脑认知发展研究的9-11岁青少年进行前瞻性表征,这些青少年在第一年经历过mTBI,并与骨科损伤和非损伤个体的对照组进行比较;在分析中考虑了一系列广泛的损伤前因素。结果:在基线(9-10岁)和第一年(10-11岁)期间,135名青少年患有mTBI,其中110人首次发生mTBI。在1年的研究访问中,npd的患病率在损伤组之间具有可比性,mTBI不能预测npd在1年的发生率。损伤前精神病学诊断显著预测npd (NPD-current [NPD-C]组:OR=2.18, 95% CI=1.30-3.61, p=0.003; NPD-any [NPD-A]组:OR=1.70, 95% CI=1.16-2.52, p=0.006),自我报告的西班牙裔与第一年npd发生率较低相关(NPD-C组:OR=0.19, 95% CI=0.03-0.78, p=0.018; NPD-A组:OR=0.57, 95% CI=0.31-0.98, p=0.043)。结论:这些结果表明,对于非临床选择的mTBI青少年,在儿童期晚期损伤后的第一年,mTBI与npd的差异发生率无关。损伤前精神病史可预测npd,自我报告的西班牙裔在第一年预测npd的几率较低。未来的研究需要进一步表征青春期儿童mTBI后的精神后遗症,以确定有针对性的预防和干预策略的风险和保护因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mild Traumatic Brain Injury and Psychiatric Disorders in Year 1 of the Adolescent Brain Cognitive Development (ABCD) Study.

Objective: Pediatric mild traumatic brain injury (mTBI) is a major public health concern. New psychiatric disorders (NPDs) can arise after mTBI, yet postinjury NPDs in nonclinical samples remain poorly understood.

Methods: NPDs were prospectively characterized for youths ages 9-11 years who experienced an mTBI in their first year of participation in the Adolescent Brain Cognitive Development study, compared with control groups of orthopedically injured and noninjured individuals; a broad set of preinjury factors was accounted for in analyses.

Results: Between baseline (ages 9-10) and year 1 (ages 10-11), 135 youths had an mTBI, with 110 incurring a first lifetime mTBI. The prevalence of NPDs at the year-1 study visit was comparable among the injury groups, and mTBI did not predict NPDs at year 1. Preinjury psychiatric diagnoses significantly predicted NPDs (NPD-current [NPD-C] group: OR=2.18, 95% CI=1.30-3.61, p=0.003; NPD-any [NPD-A] group: OR=1.70, 95% CI=1.16-2.52, p=0.006), and self-reported Hispanic ethnicity was associated with lower odds of NPDs at year 1 (NPD-C group: OR=0.19, 95% CI=0.03-0.78, p=0.018; NPD-A group: OR=0.57, 95% CI=0.31-0.98, p=0.043).

Conclusions: These results suggest that for nonclinically selected youths with mTBI, in the first year after late childhood injury, mTBI is not associated with differential odds of NPDs. Preinjury psychiatric history predicted NPDs, and self-reported Hispanic ethnicity predicted lower odds of NPDs at year 1. Future studies are needed to further characterize psychiatric sequelae after pediatric mTBI across adolescence to identify risk and protective factors for targeted prevention and intervention strategies.

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来源期刊
CiteScore
5.30
自引率
3.40%
发文量
67
审稿时长
6-12 weeks
期刊介绍: As the official Journal of the American Neuropsychiatric Association, the premier North American organization of clinicians, scientists, and educators specializing in behavioral neurology & neuropsychiatry, neuropsychology, and the clinical neurosciences, the Journal of Neuropsychiatry and Clinical Neurosciences (JNCN) aims to publish works that advance the science of brain-behavior relationships, the care of persons and families affected by neurodevelopmental, acquired neurological, and neurodegenerative conditions, and education and training in behavioral neurology & neuropsychiatry. JNCN publishes peer-reviewed articles on the cognitive, emotional, and behavioral manifestations of neurological conditions, the structural and functional neuroanatomy of idiopathic psychiatric disorders, and the clinical and educational applications and public health implications of scientific advances in these areas. The Journal features systematic reviews and meta-analyses, narrative reviews, original research articles, scholarly considerations of treatment and educational challenges in behavioral neurology & neuropsychiatry, analyses and commentaries on advances and emerging trends in the field, international perspectives on neuropsychiatry, opinions and introspections, case reports that inform on the structural and functional bases of neuropsychiatric conditions, and classic pieces from the field’s rich history.
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