颅脑外伤后器质性人格改变的临床分析

目的探讨颅脑外伤后器质性人格改变的发生率、症状特点及其相关因素。方法以脑外伤后进行工伤精神伤残鉴定的患者为研究对象,在治疗终结后,根据中国精神疾病分类与诊断标准(CCMD-3)对这些伤者的器质性人格改变情况进行诊断,并依据诊断标准中所罗列的人格改变症状表现,进行评分及统计分析。结果诊断为脑外伤后器质性人格改变者22例,占脑外伤工伤鉴定案例的19%。各临床症状的出现率为:易激惹72.7%;意志缺乏72.7%;孤僻退缩59.1%;缺乏亲密人际关系和情感平淡分别为54.5%;情绪不稳50.0%;自我中心和冲动性行为分别为45.5%;情感幼稚27.3%;情感脆弱、固执、偏执多疑、欲望增强分别为22.7%;言语粘滞、欣快、伦理道德观念减弱分别为13.6%。结论颅脑外伤后器质性人格改变发生率较高,应引起临床医师的重视。

The analysis of clinical features of organic personality disorders post-traumatic brain injury

ObjectiveTo explore the incidence of organic personality disorder, clinical features and related factors of post-traumatic brain injuries. Methods116 patients with traumatic brain injury were assessed by two psychiatrists based on the criteria of organic personality disorder of CCMD-3. ResultsOf the 116 patients, 22(19.0%) had met the criteria of organic personality disorder of CCMD-3.The occurrence of the clinical symptoms of personality disorder after traumatic brain injury were irritableness (72.7%), hypobulia (72.7%), solitary withdrawal (59.1%), lack of intimacy and apathy (54.5%) separately, emotional lability 50.0%, egocentricity and impulse 45.5% separately, emotional childish (27.3)%, emotional fragility ,stubbornness, paranoid and hyperlust (22.7%) separately, viscosity of speech, euphoria and instinct incontinence (13.6%) separately. ConclusionThere is a high incidence of the organic personality disorders in the patients with brain injury. It is necessary to give the interventions of mental heath to the patients with mental disorders after their head injuries.