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[Psychopathologic deficits after polytrauma in childhood and adolescence].

PURPOSE
The aim of this report was to evaluate psychological deficits following polytrauma in childhood and adolescence as well as to detect psychological vulnerable phases during the treatment period.


METHODS
From 9/92 to 12/98, 41 polytrauma patients (18a or younger) were treated at the University of Vienna Medical School, Trauma Center. Out of the 28 survivors, patients with head injuries and congenital neurological deficits were excluded, leaving 10 young patients that were eligible for psychological testing after a mean follow-up of 3.4 years (range, 1 to 7 years). Besides catamnesis and diagnostic interviews, an evaluation of cognitive functions as well as personality tests were performed.


RESULTS
The diagnostic interviews revealed mild psychiatric symptoms in 2/10 patients, but the cognitive functions did not show any deficits compared to normal values. The personality tests presented stress-avoiding strategies and an increased anxiety sensitivity in 2/10 patients. The catamnesis constantly revealed 2 vulnerable phases in all patients: 1. the transfer from the intensive care unit to the normal ward, 2. the retransfer to the domestic field after a long hospital stay.


CONCLUSIONS
The present report suggests that the long-term psychological outcome following polytrauma in childhood and adolescence may be good, without any major disorders. The described critical phases during treatment demonstrate that psychological support in the young, severely injured patient should start very early on at the intensive care unit.