Psychiatric Symptoms, Neurocognitive Function and Quality of Life according to Brain-MRI Findings in the Traumatic Brain Injury Patients

Kim, Ji Min; Sung, Yu Mi; Yun, Kyu Wol; Kim, Young Chul; Lim, Weon Jeong; Kim, Soo In

Abstract

OBJECTIVES
This study was intended to compare psychiatric symptoms, neurocognitive function and quality of life between normal finding group and abnormal finding group on Brain-MRI. We investigated which variables were related to quality of life (QOL) in traumatic brain injury (TBI) patients.
METHODS
Among thirty nine patients who had mild to moderate TBI, twenty two patients (57%) showed abnormal brain MRI findings correlated with their injury and 17 patients (43%) showed normal or nonspecific brain MRI findings. All patients completed Symptom check list-90-revised (SCL-90-R), Beck depression inventory (BDI), State-trait anxiety inventory (STAI), Korean version of the Smith Kline Beecham Quality of Life scale (KvSBQOL) and Marlowe-Crown Social Desirability Scale (MCSDS). Two psychiatrists assessed the patients using Hamilton rating scale for depression (HAMD), Hamilton anxiety scale (HAMA) and Functional assessment scale (FAS). In addition, Korean Wechsler Adult intelligence Scale (K-WAIS), Rey-Kim Memory Test (R-KMT) and Kims frontal-executive neuropsychological test (KF-ENT) were assessed.
RESULTS
On FAS, the mean score was significantly lower in the abnormal finding on B-MRI group than the normal finding group (p=0.014). In the patients with abnormal MRI findings, the QOL scores significantly correlated with several subscales of SCL-90-R (obsessive-compulsive, depression, anxiety, global severity index and positive symptom total), FAS and memory quotient after controlling for MCSDS. However, in the patients with normal MRI findings, QOL scores significantly correlated with BDI and all subscales of SCL-90-R. When all pertinent variables were entered in stepwise regression analysis, depression (p<0.05) and interpersonal sensitivity (p<0.05) subscales of SCL-90-R explained 38.5% and 17.7% of the variance of the QOL score in patients with abnormal MRI findings. As for the patients with normal MRI findings, depression (p<0.05) subscale of SCL-90-R accounted for 54.2% of the variance of the QOL score.
CONCLUSION
TBI patients who have persisting abnormal brain findings suffered from impaired daily functioning. Depression and interpersonal sensitivity explained 55% of the variance of the QOL together. In the patients with normal brain MRI findings, objective depression or anxiety did not correlate with QOL whereas subjective depressive symptom accounted for 54.2% of the variance of the QOL. This study suggests that subjective psychiatric symptoms including depression significantly correlated with the subjective QOL of TBI patients regardless of their brain MRI finding.