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Brain Injured Patients versus Multiple Trauma Patients: Some Neurobehavioral and Psychopathological Aspects

Frénisy, Marie-Claude PhD; Bénony, Hervé PhD; Chahraoui, Khadija PhD; Minot, Delphine MSc; d’Athis, Philippe PhD; Pinoit, Jean-Michel MD; Freysz, Marc MD, PhD

Journal of Trauma and Acute Care Surgery: May 2006 - Volume 60 - Issue 5 - p 1018-1026
doi: 10.1097/01.ta.0000215977.00034.c2
Original Articles

Background: The study aims to describe the neurobehavioral and psychopathological disorders in road crash victims with cerebral lesions compared with multiple trauma sufferers with no brain damage.

Methods: This study compares the neuropsychological and psychopathological developments of two groups of road crash victims (25 severe brain injuries (SBI) and 25 multiple traumas (MULT)) on the basis of the Neurobehavioral Scale, the SCL 90-R and the State/Trait Anxiety Scale.

Results: On the basis of the Neurobehavioral Scale, it was clear that the SBI patients suffered from significantly more disorders of type factor 1 (self-appraisal and flexible thinking), factor II (withdrawal), factor III (mood swings, irritability, disinhibition, excitement), factor IV (attention, slower motor responses, and mental fatigue), factor V (articulatory problems, problems of oral expression, and oral comprehension) and nonfactored disorders (exaggerated somatic concerns). On the SCL 90-R scale, we observed a higher level of obsessive symptoms in the SBI patients, whereas there was no significant difference between the two groups on the State/Trait Anxiety Scale. Unexpected results indicated that the multiple trauma patients suffered from memory troubles (60%), concept disorganization (32%), loss of initiative (36%), irritability (52%), unusual thought content (40%), mood swings (40%), attention difficulties (24%), suspiciousness (48%), and feelings of guilt (36%).

Conclusion: Even though multiple trauma sufferers do not receive a psychologic assessment of their cerebral functioning, and do not benefit from any rehabilitation, they exhibit neurobehavioral and psychopathological disorders which need to be taken into account when designing rehabilitation programs. This study points toward new therapeutic methods for the treatment of multiple trauma sufferers.

From the Surgical and Traumatologic Intensive Care Unit of Dijon University Hospital and Laboratory of Clinical and Social Psychology (LPCS), University of Burgundy, France.

Submitted for publication April 15, 2004.

Accepted for publication February 16, 2006.

Supported, in part, by the Dijon University Hospital (France).

Address for Reprints: Frénisy Marie-Claude, PhD, SRAU—Hôpital Général-3, Rue du Faubourg Raines, BP: 1519 21033 Dijon Cedex, France; email:

© 2006 Lippincott Williams & Wilkins, Inc.