F-1-01-07
ANXIETY AND DEPRESSION IN CAREGIVERS SUPPORTING PEOPLE WITH TRAUMATIC BRAIN INJURIES.
G. Truman & C. Stevenson (Rehabilitation Studies Unit, The University of Sydney & Royal Rehabilitation Centre Sydney, Sydney, Australia)
Purpose: The purpose of this study was to determine the relationships between the measures of anxiety and depression in this caregiver population and to explore the relationship between these measures and self rated measure of strain.
Method: Interviews of 96 caregivers supporting people with TBI were conducted. The General Health Questionnaire (GHQ) and the Hospital Anxiety and Depression Scale (HADS) were administered, along with a visual analogue scale of strain.
Results: Univariate analyses revealed high correlations between GHQ subscales, HADS anxiety, HADS depression and self-rated strain. Stepwise multiple linear regression revealed that GHQ insomnia and anxiety, HAD depression and HAD anxiety were significant predictors of self rated strain (R2=0.60).
Conclusion: The GHQ and HADS are reliable and valid measures of strain in this caregiver population. However, subscales contribute uniquely to self-reported strain, and therefore a combination of these indices should be used in clinical screening and research in this area.
F-1-01-08
ON THE APPLICATION OF BIOCHEMICAL MARKERS IN BRAIN INJURY REHABILITATION.
Christer Tengvar, A R Fugl-Meyer, Bjorn Johansson (Department of Rehabilitation Medicine, Uppsala University, Uppsala, Sweden)
Purpose: To emphasize for those involved in brain injury rehabilitation the possible advantages of measurements of CNS marker proteins known to leak into cerebrospinal fluid (CSF) after brain damage. In brain injury the early assessment of prognosis and hence evaluation of the rehabilitation potential is often ambiguous. Patients may be in coma or in a vegetative state, but CT or MRI may reveal only discrete parenchymal changes.
Different methods: Recent biotechnical advantages have made it possible to identify and quantify CSF contents after various conditions afflicting the brain. The brain is equipped with several proteins that are more or less specific for its various cellular compartments. Examples ar S-100, mainly found in protoplasmatic and fibrillary astrocytes and glial fibrillary acid protein (GFAp) located to the latter cell-type. Neuron specific enolase (NSE) is present throughout the entire neuron and phosphorylated neuronal filaments dominates in the axoplasm. Myelin basic protein (MBP) is found in oligodendrocytes, whereas synaptophysin build up synaptic vesicles in presynaptic boutons.
Conclusion: This presentation has focused on conceivable advantages of posttraumatic early determinations in CSF and serum of strategically located CNS marker proteins. These substances may to that end in greater detail reveal the topography of acute as well as delayed cell injury in the brain, phenomena that are of great importance not only for medical intervention but also for the elaboration of a plausible prognosis and hence adequate rehabilitation strategies.
