Neuropsychological impairment in children following head injury

There is a high incidence of head injury in children, yet few studies have systematically studied cognitive outcome. This study was designed as a survey to (a) establish the nature of intellectual and neuropsychological deficits that occur after head injuries of differing severity in children aged 6 to 14 years, (b) establish the nature of recovery curves in the first year after injury, and (c) determine which medical and psychosocial factors are associated with poor cognitive outcome and which functions show persisting impairment. From 1134 children admitted with head injury to Red Cross and Groote Schuur Hospitals during a 2-year period, a consecutive sample of all those who had post-traumatic amnesia (PTA) over 1 hour, a compound depressed or basal skull fracture, a seizure, or any evidence of neurological involvement, was collected (n=388). Further requirements that they should be between 6 and 14 years, English or Afrikaans speaking, and have no history of significant cerebral pathology or mental retardation, reduced the sample to 123 children. Severity groups were formed according to the length of PTA: 56 moderates (PTA less than 1 day), 40 severes (PTA 1 to 7 days), and 28 very severes (PTA more than 7 days). They were matched for age, sex, socioeconomic status and ethnic group with 46 controls who had traumatic injury not involving the head. Detailed accident, medical and psychosocial data were collected. The children were assessed on a battery of tests covering intelligence, language, motor speed, visuographic and memory functions, as soon as they were out of PTA (Tl), 3 months later (T2), and at 1-year post-injury (T3). The 4 groups are compared at each interval on Tukey' s studentized range test and the extent of recovery within and between the groups is compared by repeated measures analysis of variance

Malingering in clinical practice with specific reference to psychiatry and psychology

No Abstrac

Memory tests for use with brain damaged adults in a multiracial general hospital : a preliminary validation study

Bibliography: pages 158-169.A battery of three verbal and three visual tests was developed to meet a need for a test of memory functions for use with patients from different racial, cultural, and socioeconomic backgrounds. The test performance of 35 patients with diagnoses implying disorders of the limbic system was compared with that of 35 normal controls matched for race, age, intelligence and sex. Discriminant analysis of the verbal and visual test scores achieved 100% correct classification of the 27 patients with bilateral damage, but 3% of the normal controls were misclassified. There was a clear trend for the performance of the 3 patients with left temporal lobe damage to be impaired on the verbal tests, and the performance of the 5 patients with right temporal lobe damage to be impaired on the visual tests. Race, which tends to be correlated with socioeconomic and education levels, had no significant effect on the test scores of the 34 White, 28 Coloured, and 8 African subjects. Test scores were not significantly effected by age, intelligence or sex. Further studies to achieve cross-validation are indicated

Malingering in clinical practice with specific reference to psychiatry and psychology

The original publication is available at http://www.samj.org.zaENGLISH SUMMARY : Malingering is the intentional simulation of illness for an external gain. It can occur in any medical illness and most clinicians will encounter this problem at some point in their clinical practice. Malingering occurs most often in a medicolegal setting where the external gain is monetary compensation for disability. However, in day-to-day practice most clinicians will probably be confronted with simulation in the context of avoiding work due to illness. Many clinicians may also experience the opposite situation, namely where patients try to hide illness or diminish the degree of symptoms in order to return to work or to qualify for an insurance policy.Publisher’s versio