■臨床医のために
頭部外傷後精神障害の治療について
舘野 周, 大久保 善朗
日本医科大学精神医学教室
Treatment of Psychiatric Disorder following Traumatic Brain Injury
Amane Tateno and Yoshiro Okubo
Department of Neuropsychiatry, Nippon Medical School
Psychiatric disorders following traumatic brain injury (TBI) have negative influence on the recovery from TBI (e.g., they worsen the effect of rehabilitation, psychosocial function, activity of daily living, quality of life, relations with family members, etc.). Although psychiatric disorders are frequent complications of TBI (e.g., mood disorder 6∼77%, anxiety disorder 11∼70%, psychotic disorder 2∼20%, and problematic behavior 11∼90%), most of them are misdiagnosed and not treated adequately. Treatment of psychiatric disorder following TBI is not different from treatment of primary psychiatric disorder. TBI patients, however, are more sensitive to the side effects of medications, and therefore we should treat them by (1) starting low and going slow, (2) setting an adequate therapeutic trail with regard to dosage and duration of treatment, (3) frequent assessment during the treatment period, and (4) paying attention to adverse effects and drug interactions. Since psychiatric disorders may worsen the recovery process from TBI, successful treatment is especially important for TBI patients. It is essential for clinicians to be aware of any psychiatric disorders following TBI and to treat them properly.
日医大医会誌 2005; 1(1), 17-20
Key words
traumatic brain injury, psychiatric disorder, International Classification of Disease (ICD-10), psychotropic drug
Correspondence to
Amane Tateno, Department of Neuropsychiatry, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
E-mail：amtateno@nms.ac.jp
受付：2004年12月3日 受理：2004年12月28日 |
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