metricas
covid
Buscar en
Revista Colombiana de Psiquiatría
Toda la web
Inicio Revista Colombiana de Psiquiatría Alteraciones cognitivas, emocionales y comportamentales a largo plazo en pacient...
Journal Information
Vol. 39. Issue 4.
Pages 716-731 (December 2010)
Share
Share
Download PDF
More article options
Vol. 39. Issue 4.
Pages 716-731 (December 2010)
Artículos originales
Full text access
Alteraciones cognitivas, emocionales y comportamentales a largo plazo en pacientes con trauma craneoencefálico en Cali, Colombia*
Cognitive, Emotional, and Behavioral Disorders in Patients with Long-term Traumatic Brain Injury in Cali, Colombia
Visits
2452
María Cristina Quijano1, Juan Carlos Arango Lasprilla2,
Corresponding author
lasprilla50@hotmail.com

Correspondencia: Juan Carlos Arango Lasprilla, 730 E Broad Street 4th floor, Room 4230a, Richmond, VA 23219 PO Box 843038, Estados Unidos
, María Teresa Cuervo3
1 MsC en Neuropsicología, docente del Departamento de Ciencias Sociales. Directora del Grupo de Medición y Evaluación Psicológica. Cali, Colombia
2 PhD Grupo de Rehabilitación en Salud. Facultad de Medicina. Universidad de Antioquia. Medellín, Colombia
3 Especialista en Neuropsicología Infantil. Asistente de investigación del Grupo de Medición y Evaluación Psicológica. Cali, Colombia
This item has received
Article information
Resumen
Introducción

El trauma craneoencefálico (TCE) es una de las principales causas de muerte y discapacidad en personas jóvenes en Colombia. Aquellos que logran sobrevivir a un TCE suelen quedar con secuelas de problemas cognitivos, emocionales y comportamentales que interfieren con su vida familiar, social y laboral. Pese a la importancia de estos problemas, no existen investigaciones en Colombia en esta área.

Objetivo

Determinar a largo plazo las alteraciones cognoscitivas, emocionales y neurocomportamentales de un grupo de pacientes con TCE de la ciudad de Cali, Colombia.

Método

A cada uno de los 60 participantes (30 sujetos con trauma de cráneo moderado y severo del Hospital Universitario del Valle y del Centro de Rehabilitación Neurológica Teravida y 30 controles) se le administró la batería neuropsicológica breve (Neuropsi) y el Inventario de Funcionamiento Neurocomportamental (IFN).

Resultados

Comparado con el grupo control, los pacientes con TCE presentaron puntuaciones significativamente más bajas en las pruebas de atención y concentración, memoria a corto y largo plazo, lenguaje y funciones ejecutivas, y más altas en depresión, síntomas somáticos y problemas de comunicación.

Conclusión

Los pacientes con TCE a largo plazo tienen no sólo dificultades cognitivas, sino síntomas depresivos, somáticos y problemas de comunicación, que señalan la necesidad de que reciban atención desde los servicios de salud en estas dos áreas (cognitivo y emocional-comportamental), involucrándolos en programas de rehabilitación cognoscitiva, psicoterapéuticos y psicoeducativos, que permitan mejorar la calidad de vida tanto de los pacientes como de sus familias.

Palabras clave:
traumatismos craneoencefálicos
evaluación de la discapacidad
complicaciones
Abstract
Introduction

Traumatic Brain Injury (TBI) is one of the primary causes of death and disability in Colombia. The objective of the present study was to determine the cognitive, emotional, and neurobehavioral functioning of a group of individuals with TBI in Cali, Colombia.

Method

A neuropsychologist administered a comprehensive neuropsychological evaluation (Neuropsi) and the Spanish-language version of the Neurobehavioral Functional Inventory (NFI) to 30 individuals with TBI from Teravida Neurological Rehabilitation Center and del Valle University Hospital in Cali, Colombia and 30 healthy controls.

Results

Compared to controls, the patients scored significantly worse on attention, memory, executive functioning, and language tests. The patients scored significantly higher than controls on three sub-scales of the NFI: Depression, somatic symptoms, and communication problems.

Conclusion

Patients with long-term TBI not only have cognitive difficulties, but also depressive symptoms, somatic, and communication problems, which underlines the need for these patients to receive care from health services in these two areas (cognitive and emotional-behavioral), involving them in programs of cognitive rehabilitation, psychotherapy, and psychoeducation to improve the quality of life of the patients and their families.

Key words:
Brain injuries
disability evaluation
complications
Full text is only aviable in PDF
Referencias
[1]
AA Hyder, CA Wunderlich, P Puvanachandra, G Gururaj, OC Kobusingye.
The impact of traumatic brain injuries: a global perspective.
NeuroRehabilitation, 22 (2007), pp. 341-353
[2]
MJ De Silva, I Roberts, P Perel, P Edwards, MG Kenward, J Fernandes, et al.
Patient outcome after traumatic brain injury in high-, middle- and low-income countries: analysis of data on 8927 patients in 46 countries.
Int J Epidemiol, 38 (2009), pp. 452-458
[3]
S Ríos, B Castaño, M Bernabeu.
Farmacoterapia de las secuelas cognitivas secundarias a traumatismo craneoencefálico.
Rev Neurol, 45 (2007), pp. 563-570
[4]
JC Arango-Lasprilla, M Rosenthal, J DeLuca, DX Cifu, R Hanks, E Komaroff.
Functional outcomes from inpatient rehabilitation after traumatic brain injury: how do Hispanics fare?.
Arch Phys Med Rehabil, 88 (2007), pp. 11-18
[5]
M Oddy, T Coughlan, A Tyerman, D Jenkins.
Social adjustment after closed head injury: a further follow-up seven years after injury.
J Neurol Neurosurg Psychiatry, 48 (1985), pp. 564-568
[6]
RC Conkey.
Psychological changes associated with head injuries.
Arch Psychol, 232 (1938), pp. 1-62
[7]
J Ruesch, BE Moore.
Measurement of intellectual functions in the acute stage of head injury.
Arch Neurol Psychiatry, 50 (1943), pp. 165-170
[8]
WR Reynell.
A psychometric method of determining intellectual loss following head injury.
J Ment Sci, 90 (1944), pp. 710-719
[9]
JS Kreutzer, WA Gordon, M Rosenthal, MA Marwitz.
Neuropsychological characteristics of patients with brain injury: preliminary findings from a multicenter investigation.
J Head Trauma Rehabil, 8 (1993), pp. 47-59
[10]
DA Kersel, NV Marsh, JH Havill, JW Sleigh.
Neuropsychological functioning during the year following severe traumatic brain injury.
Brain Inj, 15 (2001), pp. 283-296
[11]
SR Millis, M Rosenthal, TA Novack, M Sherer, TG Nick, JS Kreutzer, et al.
Long-term neuropsychological outcome after traumatic brain injury.
J Head Trauma Rehabil, 16 (2001), pp. 343-355
[12]
Rehabilitation of the adult and child with traumatic brain injury, 3a ed.,
[13]
K Verger, JM Serra-Grabulosa, C Junqué, A Álvarez, D Bartrés-Faz, JM Mercader.
Estudio de las secuelas a largo plazo de los traumatismos craneoencefálicos: evaluación de la memoria declarativa y procedimental y de su sustrato neuroanatómico.
Rev Neurol, 33 (2001), pp. 30-34
[14]
DT Stuss, LL Stethem, H Hugenholtz, MT Richard.
Traumatic brain injury: a comparison of three clinical tests, and analysis of recovery.
Clin Neuropsychol, 3 (1989), pp. 145-156
[15]
DT Stuss, LL Stethem, H Hugenholtz, T Picton, J Pivik, MT Richard.
Reaction time after head injury: fatigue, divided and focused attention, and consistency of performance.
J Neurol Neurosurg Psychiatry, 52 (1989), pp. 742-748
[16]
J Ponsford, G Kinsella.
The use of a rating scale of attentional behaviour.
Neuropsychol Rehabil, 1 (1991), pp. 241-257
[17]
P Zoccolotti, A Mataño, G Deloche, A Cantagallo, A Passadori, M Leclercq, et al.
Patterns of attentional impairment following closed head injury: a collaborative European study.
Cortex, 36 (2000), pp. 93-107
[18]
HS Levin, RG Grossman, JE Rose, G Teasdale.
Long-term neuropsychological outcome of closed head injury.
J Neurosurg, 50 (1979), pp. 412-422
[19]
J Abutalebi, S Cappa.
Language disorders.
Cognitive neurology: a clinical textbook, pp. 43-66
[20]
M Gil, M Cohen, C Korn, Z Groswasser.
Vocational outcome of aphasic patients following severe traumatic brain injury.
Brain Inj, 10 (1996), pp. 39-45
[21]
KM Yorkston, KM Jaffe, NL Polissar, S Liao, GC Fay.
Written language production and neuropsychological function in children with traumatic brain injury.
Arch Phys Med Rehabil, 78 (1997), pp. 1096-1102
[22]
YE Guo, L Togher.
The impact of dysarthria on everyday communication after traumatic brain injury: a pilot study.
Brain Inj, 22 (2008), pp. 83-97
[23]
O Papazian, I Alfonso, RJ Luzondo.
Trastornos de las funciones ejecutivas.
Rev Neurol, 42 (2006), pp. S45-S50
[24]
M Ariza-González, R Pueyo-Benito, JM Serra-Grabulosa.
Secuelas neuropsicológicas de los traumatismos craneoencefálicos.
Anales Psicol, 20 (2004), pp. 303-316
[25]
HG Canto, S Fernández, A Bilbao, MT Martín, ML Delgado.
Toma de decisiones en personas con traumatismo craneoencefálico severo.
Trauma Fund Mapf, 18 (2007), pp. 80-86
[26]
A Caracuel, A Verdejo-García, R Vilar-López, M Pérez-García, I Salinas, G Cuberos, et al.
Frontal behavioral and emotional symptoms in Spanish individuals with acquired brain injury and substance use disorders.
Arch Clin Neuropsychol, 23 (2008), pp. 447-454
[27]
DW Hiott, L Labbate.
Anxiety disorders associated with traumatic brain injuries.
NeuroRehabilitation, 17 (2002), pp. 345-355
[28]
EL Moore, L Terryberry-Spohr, DA Hope.
Mild traumatic brain injury and anxiety sequelae: a review of the literature.
Brain Inj, 20 (2006), pp. 117-132
[29]
R Kant, JD Duffy, A Pivovarnik.
Prevalence of apathy following head injury.
Brain Inj, 12 (1998), pp. 87-92
[30]
R Van Reekum, I Bolago, MA Finlayson, S Garner, PS Links.
Psychiatric disorders after traumatic brain injury.
Brain Inj, 10 (1996), pp. 319-327
[31]
IJ Baguley, J Cooper, K Felmingham.
Aggressive behavior following traumatic brain injury: how common is common?.
J Head Trauma Rehabil, 21 (2006), pp. 45-56
[32]
S Shukla, BL Cook, S Mukherjee, C Godwin, MG Miller.
Mania following head trauma.
Am J Psychiatry, 144 (1987), pp. 93-96
[33]
L Keyser, AD Witol, JS Kreutzer, M Rosenthal.
A multi-center investigation of neurobehavioral outcome after traumatic brain injury.
NeuroRehabilitation, 5 (1995), pp. 255-267
[34]
JE Max, SL Koele, WL Smith Jr, Y Sato, SD Lindgren, DA Robin, et al.
Psychiatric disorders in children and adolescents after severe traumatic brain injury: a controlled study.
J Am Acad Child Adolesc Psychiatry, 37 (1998), pp. 832-840
[35]
MR Hibbard, S Uysal, K Kepler, J Bogdany, J Silver.
Axis I psychopathology in individuals with traumatic brain injury.
J Head Trauma Rehabil, 13 (1998), pp. 24-39
[36]
RE Jorge, RG Robinson, SV Arndt, AW Forrester, F Geisler, SE Starkstein.
Comparison between acute- and delayed-onset depression following traumatic brain injury.
J Neuropsychiatry Clin Neurosci, 5 (1993), pp. 43-49
[37]
JR Fann, WJ Katon, JM Uomoto, PC Esselman.
Psychiatric disorders and functional disability in outpatients with traumatic brain injuries.
Am J Psychiatry, 152 (1995), pp. 1493-1499
[38]
S Deb, I Lyons, C Koutzoukis, I Ali, G McCarthy.
Rate of psychiatric illness 1 year after traumatic brain injury.
Am J Psychiatry, 156 (1999), pp. 374-378
[39]
RE Kennedy, L Livingston, A Riddick, JH Marwitz, JS Kreutzer, ND Zasler.
Evaluation of the Neurobehavioral Functioning Inventory as a depression screening tool after traumatic brain injury.
J Head Trauma Rehabil, 20 (2005), pp. 512-526
[40]
E Kim, EC Lauterbach, A Reeve, DB Arciniegas, KL Coburn, MF Méndez, et al.
Neuropsychiatric complications of traumatic brain injury: a critical review of the literature (a report by the ANPA Committee on Research).
J Neuropsychiatry Clin Neurosci, 19 (2007), pp. 106-127
[41]
R Van Reekum, T Cohen, J Wong.
Can traumatic brain injury cause psychiatric disorders?.
J Neuropsychiatry Clin Neurosci, 12 (2000), pp. 316-327
[42]
N Brooks, L Campsie, C Symington, A Beattie, W McKinlay.
The effects of head injury on patient and relative within seven years of injury.
J Head Trauma Rehabil, 2 (1987), pp. 1-13
[43]
IV Thomsen.
Late outcome of very severe blunt head trauma: a 10-15 year second follow-up.
J Neurol Neurosurg Psychiatry, 47 (1984), pp. 260-268
[44]
RE Jorge, RG Robinson, SE Starkstein, SV Arndt.
Depression and anxiety following traumatic brain injury.
J Neuropsychiatry Clin Neurosci, 5 (1993), pp. 369-374
[45]
DJ Schretlen, AM Shapiro.
A quantitative review of the effects of traumatic brain injury on cognitive functioning.
Int Rev Psychiatry, 15 (2003), pp. 341-349
[46]
L Himanen, R Portin, H Isoniemi, H Helenius, T Kurki, O Tenovuo.
Longitudinal cognitive changes in traumatic brain injury: a 30-year follow-up study.
[47]
ED Bigler.
Distinguished Neuropsychologist Award Lecture 1999. The lesion(s) in traumatic brain injury: implications for clinical neuropsychology.
Arch Clin Neuropsychol, 16 (2001), pp. 95-131
[48]
FUNDCOMA (Fundación Colombiana para el manejo del trauma cerebral) [Internet], Fundcoma, (2004),
[49]
D Girard, J Brown, M Burnett-Stolnack, N Hashimoto, S Hier-Wellmer, OZ Perlman, et al.
The relationship of neuropsychological status and productive outcomes following traumatic brain injury.
Brain Inj, 10 (1996), pp. 663-676
[50]
F Ostrosky-Solís, A Ardila, M Rosselli.
NEUROPSI: a brief neuropsychological test battery in Spanish with norms by age and education level.
J Int Neuropsychol Soc, 5 (1999), pp. 413-433
[51]
JS Kreutzer, JH Marwitz, R Seel, CD Serio.
Validation of a neurobehavioral functioning inventory for adults with traumatic train injury.
Arch Phys Med Rehabil, 77 (1996), pp. 116-124
[52]
F Pereira, J Téllez-Vargas, A Méndez, A Muñoz, AM Torres.
Traducción, adaptación y validación al español de la escala Neurobehavioral Functioning Inventory, Fase I.
Avances Psiquiatr Biol, 8 (2007), pp. 153-178
[53]
M Lippert-Grüner, J Kuchta, M Hellmich, N Klug.
Neurobehavioural deficits after severe traumatic brain injury (TBI).
Brain Inj, 20 (2006), pp. 569-574
[54]
NR Varney, JS Martzke, RJ Roberts.
Major depression in patients with closed head injury.
Neuropsychology, 1 (1987), pp. 7-9
[55]
BS Alderfer, DB Arciniegas, JM Silver.
Treatment of depression following traumatic brain injury.
J Head Trauma Rehabil, 20 (2005), pp. 544-562
[56]
RE Jorge, SE Starkstein.
Pathophysiologic aspects of major depression following traumatic brain injury.
J Head Trauma Rehabil, 20 (2005), pp. 475-487
[57]
E Bay, BM Hagerty, RA Williams.
Depressive symptomatology after mild-to-moderate traumatic brain injury: a comparison of three measures.
Arch Psychiatr Nurs, 21 (2007), pp. 2-11
[58]
E Bay, J Donders.
Risk factors for depressive symptoms after mild-to-moderate traumatic brain injury.
Brain Inj, 22 (2008), pp. 233-241
[59]
N Chaytor, N Temkin, J Machamer, S Dikmen.
The ecological validity of neuropsychological assessment and the role of depressive symptoms in moderate to severe traumatic brain injury.
J Int Neuropsychol Soc, 13 (2007), pp. 377-385
[60]
RT Seel, JS Kreutzer.
Depression assessment after traumatic brain injury: an empirically based classification method.
Arch Phys Med Rehabil, 84 (2003), pp. 1621-1628
[61]
JS Kreutzer, RT Seel, E Gourley.
The prevalence and symptom rates of depression after traumatic brain injury: a comprehensive examination.
Brain Inj, 15 (2001), pp. 563-576
[62]
A Bowen, V Neumann, M Conner, A Tennant, MA Chamberlain.
Mood disorders following traumatic brain injury: identifying the extent of the problem and the people at risk.
Brain Inj, 12 (1998), pp. 177-190
[63]
TQ Strom, J Kosciulek.
Stress, appraisal and coping following mild traumatic brain injury.
Brain Inj, 21 (2007), pp. 1137-1145
[64]
DB Huang, R Spiga, H Koo.
Use of the Zung depression scale in patients with traumatic brain injury: 1 year post-injury.
Brain Inj, 19 (2005), pp. 903-908
[65]
MB Glenn, T O'Neil-Pirozzi, R Goldstein, D Burke, L Jacob.
Depression amongst outpatients with traumatic brain injury.
Brain Inj, 15 (2001), pp. 811-818
[66]
JM Fleming, J Strong, R Ashton.
Cluster analysis of self-awareness levels in adults with traumatic brain injury and relationship to outcome.
J Head Trauma Rehabil, 13 (1998), pp. 39-51

Articulo empírico. Línea de Investigación en Neurociencias y Neuropsicología del Grupo de Medición y Evaluación Psicológica de los proyectos “Utilidad de la Técnica de Autogeneración en pacientes con TCE para mejorar el aprendizaje y la memoria (Registro Institucional RII-193) y caracterización neuropsicología del trauma de cráneo en un grupo de personas de la ciudad de Cali-Colombia. (Registro Institucional RII-218)”, que recibió apoyo de la Pontificia Universidad Javeriana Cali.

Conflictos de interés: los autores manifiestan que no tienen conflicto de interés en este artículo.

Copyright © 2010. Asociación Colombiana de Psiquiatría
Download PDF
Article options