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Behavioral disorders after traumatic brain injury: Why a special issue in the Annals of Physical and Rehabilitation Medicine? / Jacques Luauté in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.1-2 Titre : Behavioral disorders after traumatic brain injury: Why a special issue in the Annals of Physical and Rehabilitation Medicine? Type de document : texte imprimé Auteurs : Jacques Luauté ; Philippe Azouvi Année de publication : 2016 Article en page(s) : p.1-2 Langues : Anglais (eng) Mots-clés : comportement  lésion cérébrale  traumatisme cranien Résumé : It is now more than 150 years ago that Harlow reported the surprising case of Phineas Gage, an American railroad worker who showed profound changes in personality and behavior after a large iron rod was driven completely through his head, penetrating his left frontal lobe [1] (Fig. 1). These changes were severe enough so that his friends said that he was “no longer Gage”. Permalink : ./index.php?lvl=notice_display&id=42766 [article] Behavioral disorders after traumatic brain injury: Why a special issue in the Annals of Physical and Rehabilitation Medicine? [texte imprimé] / Jacques Luauté ; Philippe Azouvi . - 2016 . - p.1-2. Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.1-2 Mots-clés : comportement  lésion cérébrale  traumatisme cranien Résumé : It is now more than 150 years ago that Harlow reported the surprising case of Phineas Gage, an American railroad worker who showed profound changes in personality and behavior after a large iron rod was driven completely through his head, penetrating his left frontal lobe [1] (Fig. 1). These changes were severe enough so that his friends said that he was “no longer Gage”. Permalink : ./index.php?lvl=notice_display&id=42766

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Behavioral disorders after traumatic brain injury: Why and how did French recommendations for good practice emerge? / Jacques Luauté in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.3_4 Titre : Behavioral disorders after traumatic brain injury: Why and how did French recommendations for good practice emerge? Type de document : texte imprimé Auteurs : Jacques Luauté ; Jean-François Mathé Année de publication : 2016 Article en page(s) : p.3_4 Langues : Anglais (eng) Mots-clés : traumatisme crânien  lésion cérébrale  recommandation Résumé : Behavioral disorders after severe traumatic brain injury represent common important sequelae. They can occur at any time during the evolution phases and interfere in all domains of life and relationships with others. They represent a subjection for families, societies and impair the quality of the reinsertion. They often constitute a reason for refusing to admit or even excluding patients from healthcare, medicosocial, family and professional structures. The management of these disorders is not simple nor standardized and it is being confronted to the diversity and low efficacy of the usual therapeutics. Several actors in the healthcare, social, work, evaluation and justice fields have expressed their disarray concerning the management of these patients and have requested a protocol or guidelines to approach in a logical manner these behavioral disorders and treat them in the best way possible. Permalink : ./index.php?lvl=notice_display&id=42769 [article] Behavioral disorders after traumatic brain injury: Why and how did French recommendations for good practice emerge? [texte imprimé] / Jacques Luauté ; Jean-François Mathé . - 2016 . - p.3_4. Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.3_4 Mots-clés : traumatisme crânien  lésion cérébrale  recommandation Résumé : Behavioral disorders after severe traumatic brain injury represent common important sequelae. They can occur at any time during the evolution phases and interfere in all domains of life and relationships with others. They represent a subjection for families, societies and impair the quality of the reinsertion. They often constitute a reason for refusing to admit or even excluding patients from healthcare, medicosocial, family and professional structures. The management of these disorders is not simple nor standardized and it is being confronted to the diversity and low efficacy of the usual therapeutics. Several actors in the healthcare, social, work, evaluation and justice fields have expressed their disarray concerning the management of these patients and have requested a protocol or guidelines to approach in a logical manner these behavioral disorders and treat them in the best way possible. Permalink : ./index.php?lvl=notice_display&id=42769

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What are the disruptive symptoms of behavioral disorders after traumatic brain injury? A systematic review leading to recommendations for good practices / Angélique Stéfan in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.5-17 Titre : What are the disruptive symptoms of behavioral disorders after traumatic brain injury? A systematic review leading to recommendations for good practices Type de document : texte imprimé Auteurs : Angélique Stéfan ; Jean-François Mathé ; The SOMFER group Année de publication : 2016 Article en page(s) : p.5-17 Langues : Anglais (eng) Mots-clés : troubles comportementaux  lésion cérébrale  recommandation Résumé : Behavioral disorders are major sequelae of severe traumatic brain injury. Before considering care management of these disorders, and in the absence of a precise definition for TBI-related behavioral disorder, it is essential to refine, according to the data from the literature, incidence, prevalence, predictive factors of commonly admitted disruptive symptoms. Permalink : ./index.php?lvl=notice_display&id=42773 [article] What are the disruptive symptoms of behavioral disorders after traumatic brain injury? A systematic review leading to recommendations for good practices [texte imprimé] / Angélique Stéfan ; Jean-François Mathé ; The SOMFER group . - 2016 . - p.5-17. Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.5-17 Mots-clés : troubles comportementaux  lésion cérébrale  recommandation Résumé : Behavioral disorders are major sequelae of severe traumatic brain injury. Before considering care management of these disorders, and in the absence of a precise definition for TBI-related behavioral disorder, it is essential to refine, according to the data from the literature, incidence, prevalence, predictive factors of commonly admitted disruptive symptoms. Permalink : ./index.php?lvl=notice_display&id=42773

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Neurobehavioral and self-awareness changes after traumatic brain injury: Towards new multidimension / A. Arnould in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.18-22 Titre : Neurobehavioral and self-awareness changes after traumatic brain injury: Towards new multidimension Type de document : texte imprimé Auteurs : A. Arnould ; E. Dromer ; L. Rochat Année de publication : 2016 Article en page(s) : p.18-22 Langues : Anglais (eng) Mots-clés : apathie  impulsivité  anosognosie  lésion cérébrale  traumatisme crânien Résumé : Neurobehavioral and self-awareness changes are frequently observed following traumatic brain injury (TBI). These disturbances have been related to negative consequences on functional outcomes, caregiver distress and social reintegration, representing therefore a challenge for clinical research. Some studies have recently been conducted to specifically explore apathetic and impulsive manifestations, as well as self-awareness impairments in patients with TBI. These findings underlined the heterogeneity of clinical manifestations for each behavioral disturbance and the diversity of psychological processes involved. In this context, new multidimensional approaches taking into account the various processes at play have been proposed to better understand and apprehend the complexity and dynamic nature of these problematic behaviors. In addition, the involvement of social and environmental factors as well as premorbid personality traits have increasingly been addressed. These new multidimensional frameworks have the potential to ensure targeted and effective rehabilitation by allowing a better identification and therefore consideration of the various mechanisms involved in the onset of problematic behaviors. In this context, the main objective of this position paper was to demonstrate the interest of multidimensional approaches in the understanding and rehabilitation of problematic behaviors in patients with TBI. Permalink : ./index.php?lvl=notice_display&id=42776 [article] Neurobehavioral and self-awareness changes after traumatic brain injury: Towards new multidimension [texte imprimé] / A. Arnould ; E. Dromer ; L. Rochat . - 2016 . - p.18-22. Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.18-22 Mots-clés : apathie  impulsivité  anosognosie  lésion cérébrale  traumatisme crânien Résumé : Neurobehavioral and self-awareness changes are frequently observed following traumatic brain injury (TBI). These disturbances have been related to negative consequences on functional outcomes, caregiver distress and social reintegration, representing therefore a challenge for clinical research. Some studies have recently been conducted to specifically explore apathetic and impulsive manifestations, as well as self-awareness impairments in patients with TBI. These findings underlined the heterogeneity of clinical manifestations for each behavioral disturbance and the diversity of psychological processes involved. In this context, new multidimensional approaches taking into account the various processes at play have been proposed to better understand and apprehend the complexity and dynamic nature of these problematic behaviors. In addition, the involvement of social and environmental factors as well as premorbid personality traits have increasingly been addressed. These new multidimensional frameworks have the potential to ensure targeted and effective rehabilitation by allowing a better identification and therefore consideration of the various mechanisms involved in the onset of problematic behaviors. In this context, the main objective of this position paper was to demonstrate the interest of multidimensional approaches in the understanding and rehabilitation of problematic behaviors in patients with TBI. Permalink : ./index.php?lvl=notice_display&id=42776

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The evaluation of behavioural changes in brain-injured patients: SOFMER recommendations for clinical practice / Antoinette Prouteau in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.23-30 Titre : The evaluation of behavioural changes in brain-injured patients: SOFMER recommendations for clinical practice Type de document : texte imprimé Auteurs : Antoinette Prouteau ; Angélique Stéfan ; L. Wiart Année de publication : 2016 Article en page(s) : p.23-30 Langues : Anglais (eng) Mots-clés : comportement  évaluation  traumatisme cérébral Résumé : Behavioural changes are the main cause of difficulties in interpersonal relationships and social integration among traumatic brain injury (TBI) patients. The Société française de médecine physique et réadaptation (SOFMER) decided to develop recommendations for the treatment and care provision for these problem under the auspices of the French health authority, the Haute Autorité de la santé (HAS). Assessment of behaviour is essential to describe, understand and define situations, assess any change and suggest lines for intervention. The relationship of these behavioural changes with the brain lesion is likewise of crucial importance in legal and forensic expertise. Permalink : ./index.php?lvl=notice_display&id=42777 [article] The evaluation of behavioural changes in brain-injured patients: SOFMER recommendations for clinical practice [texte imprimé] / Antoinette Prouteau ; Angélique Stéfan ; L. Wiart . - 2016 . - p.23-30. Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.23-30 Mots-clés : comportement  évaluation  traumatisme cérébral Résumé : Behavioural changes are the main cause of difficulties in interpersonal relationships and social integration among traumatic brain injury (TBI) patients. The Société française de médecine physique et réadaptation (SOFMER) decided to develop recommendations for the treatment and care provision for these problem under the auspices of the French health authority, the Haute Autorité de la santé (HAS). Assessment of behaviour is essential to describe, understand and define situations, assess any change and suggest lines for intervention. The relationship of these behavioural changes with the brain lesion is likewise of crucial importance in legal and forensic expertise. Permalink : ./index.php?lvl=notice_display&id=42777

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Non pharmacological treatments for psychological and behavioural disorders following traumatic brain injury (TBI). A systematic literature review and expert opinion leading to recommendations / Laurent Wiart in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.31-41 Titre : Non pharmacological treatments for psychological and behavioural disorders following traumatic brain injury (TBI). A systematic literature review and expert opinion leading to recommendations Type de document : texte imprimé Auteurs : Laurent Wiart ; Jacques Luauté ; Angélique Stéfan Année de publication : 2016 Article en page(s) : p.31-41 Langues : Anglais (eng) Mots-clés : traumatisme cérébral  troubles du comportement  psychologie  psychothérapie  trouble cognitif  thérapie holistique  thérapie familiale Résumé : Introduction The non pharmacological approach is an important issue in the treatment of psychological and behavioural disorders in traumatic brain injury (TBI) patients. It remains nevertheless insufficiently known and defined. The objective of this work was to develop precise recommendations for caregivers and relatives. Method The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement, involving a systematic, critical review of the literature and the expert opinions of the French Society of Physical Medicine and Rehabilitation (SOFMER) group. Results 458 articles were identified, among which 98 were selected for their relevance to the theme of the research. None of the studies reached the highest level of evidence. Fifteen controlled studies reached a relatively high level of evidence (level 2); other studies were case series or expert opinions, and other articles again were reviews of the literature and theoretical points of view. The holistic approach structured into programmes, cognitive-behavioural therapy, and family and systemic therapy, despite the low levels of proof, are recommended in first intention at all stages in the evolution of TBI. Relational and adaptive approaches, rehabilitation and vocational approaches, and psychoanalytical therapies may be useful, provided that therapists are familiar with and trained in traumatic brain injury. Conclusion Despite the small number of publications and a low level of proof, a number of recommendations for the non-pharmacological approach to psychological and behavioural disorders in TBI is proposed by the consensus conference of experts. Scientific research in this domain is needed to confirm and complete these first recommendations. Permalink : ./index.php?lvl=notice_display&id=42780 [article] Non pharmacological treatments for psychological and behavioural disorders following traumatic brain injury (TBI). A systematic literature review and expert opinion leading to recommendations [texte imprimé] / Laurent Wiart ; Jacques Luauté ; Angélique Stéfan . - 2016 . - p.31-41. Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.31-41 Mots-clés : traumatisme cérébral  troubles du comportement  psychologie  psychothérapie  trouble cognitif  thérapie holistique  thérapie familiale Résumé : Introduction The non pharmacological approach is an important issue in the treatment of psychological and behavioural disorders in traumatic brain injury (TBI) patients. It remains nevertheless insufficiently known and defined. The objective of this work was to develop precise recommendations for caregivers and relatives. Method The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement, involving a systematic, critical review of the literature and the expert opinions of the French Society of Physical Medicine and Rehabilitation (SOFMER) group. Results 458 articles were identified, among which 98 were selected for their relevance to the theme of the research. None of the studies reached the highest level of evidence. Fifteen controlled studies reached a relatively high level of evidence (level 2); other studies were case series or expert opinions, and other articles again were reviews of the literature and theoretical points of view. The holistic approach structured into programmes, cognitive-behavioural therapy, and family and systemic therapy, despite the low levels of proof, are recommended in first intention at all stages in the evolution of TBI. Relational and adaptive approaches, rehabilitation and vocational approaches, and psychoanalytical therapies may be useful, provided that therapists are familiar with and trained in traumatic brain injury. Conclusion Despite the small number of publications and a low level of proof, a number of recommendations for the non-pharmacological approach to psychological and behavioural disorders in TBI is proposed by the consensus conference of experts. Scientific research in this domain is needed to confirm and complete these first recommendations. Permalink : ./index.php?lvl=notice_display&id=42780

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Drugs for behavior disorders after traumatic brain injury: Systematic review and expert consensus leading to French recommendations for good practice / David Plantier in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.42-57 Titre : Drugs for behavior disorders after traumatic brain injury: Systematic review and expert consensus leading to French recommendations for good practice Type de document : texte imprimé Auteurs : David Plantier ; Jacques Luauté ; The SOMFER group Année de publication : 2016 Article en page(s) : p.42-57 Langues : Anglais (eng) Mots-clés : traumatisme cérébral  troubles du comportement  neuroleptique  antidépresseur  bêtabloquant  stabilisateurs de l'humeur  médicament  benzodiazépine  amantadine Résumé : Objective There are no handbook or recommendations for the use of pharmacological agents to treat neurobehavioral disorders after traumatic brain injury (TBI). This work proposes a systematic review of the literature and a user guide on neuroleptics, antidepressants, beta-blockers, mood stabilizers and other medications for irritability, aggressiveness, agitation, impulsivity, depression, apathy… Method Steering, working and reading groups (62 people) were formed under the control of the French High Authority for Health (HAS) in collaboration with the SOFMER scientific society (French Society of Physical and Rehabilitation Medicine). Articles were searched by HAS officers in the Medline database from 1990 to 2012, crossing TBI and pharmacological agents. The HAS method to select, read and analyze papers is close to the PRISMA statements. Results Out of 772 references, 89 were analyzed, covering a total of 1306 people with TBI. There is insufficient evidence to standardize drug treatments for these disorders. There are however some elements to establish consensus recommendations for good clinical practice. Propranolol can improve aggression (B grade). Carbamazepine and valproate seem effective on agitation and aggression and are recommended as first line treatment (Expert Consensus [EC]). There is no evidence of efficacy for neuroleptics. Their prescription is based on emergency situation for a crisis (loxapine) but not for long-term use (EC). Antidepressants are recommended to treat depression (EC) with a higher standard of proof for Selective Serotonin Reuptake Inhibitors (SSRI, grade B). Other products are described. Conclusion The choice of treatment depends on the level of evidence, target symptoms, custom objectives, clinical experience and caution strategies. Permalink : ./index.php?lvl=notice_display&id=42783 [article] Drugs for behavior disorders after traumatic brain injury: Systematic review and expert consensus leading to French recommendations for good practice [texte imprimé] / David Plantier ; Jacques Luauté ; The SOMFER group . - 2016 . - p.42-57. Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.42-57 Mots-clés : traumatisme cérébral  troubles du comportement  neuroleptique  antidépresseur  bêtabloquant  stabilisateurs de l'humeur  médicament  benzodiazépine  amantadine Résumé : Objective There are no handbook or recommendations for the use of pharmacological agents to treat neurobehavioral disorders after traumatic brain injury (TBI). This work proposes a systematic review of the literature and a user guide on neuroleptics, antidepressants, beta-blockers, mood stabilizers and other medications for irritability, aggressiveness, agitation, impulsivity, depression, apathy… Method Steering, working and reading groups (62 people) were formed under the control of the French High Authority for Health (HAS) in collaboration with the SOFMER scientific society (French Society of Physical and Rehabilitation Medicine). Articles were searched by HAS officers in the Medline database from 1990 to 2012, crossing TBI and pharmacological agents. The HAS method to select, read and analyze papers is close to the PRISMA statements. Results Out of 772 references, 89 were analyzed, covering a total of 1306 people with TBI. There is insufficient evidence to standardize drug treatments for these disorders. There are however some elements to establish consensus recommendations for good clinical practice. Propranolol can improve aggression (B grade). Carbamazepine and valproate seem effective on agitation and aggression and are recommended as first line treatment (Expert Consensus [EC]). There is no evidence of efficacy for neuroleptics. Their prescription is based on emergency situation for a crisis (loxapine) but not for long-term use (EC). Antidepressants are recommended to treat depression (EC) with a higher standard of proof for Selective Serotonin Reuptake Inhibitors (SSRI, grade B). Other products are described. Conclusion The choice of treatment depends on the level of evidence, target symptoms, custom objectives, clinical experience and caution strategies. Permalink : ./index.php?lvl=notice_display&id=42783

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Care management of the agitation or aggressiveness crisis in patients with TBI. Systematic review of the literature and practice recommendations / Jacques Luauté in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.58-67 Titre : Care management of the agitation or aggressiveness crisis in patients with TBI. Systematic review of the literature and practice recommendations Type de document : texte imprimé Auteurs : Jacques Luauté ; David Plantier ; Laurent Wiart Année de publication : 2016 Article en page(s) : p.58-67 Langues : Anglais (eng) Mots-clés : traumatisme cérébral  agitation  agressivité  comportement  recommandation Résumé : The agitation crisis in the awakening phase after traumatic brain injury (TBI) is one of the most difficult behavioral disorders to alleviate. Current treatment options are heterogeneous and may involve excessive sedation. Practice guidelines are required by professionals in charge of TBI patients. Few reviews were published but those are old and based on expert opinions. The purpose of this work is to propose evidence-based guidelines to treat the agitation crisis. Methods The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement. Guidelines were elaborated on the basis of a systematic and critical review of the literature. Results Twenty-eight articles concerning 376 patients were analyzed. Recommendations are: when faced with an agitation crisis, the management strategy implies to search for an underlying factor that should be treated such as pain, acute sepsis, and drug adverse effect (expert opinion). Physical restraints should be discarded when possible (expert opinion). Neuroleptic agent with a marketing authorization can be used in order to obtain a quick sedation so as to protect the patient from himself, closed ones or the healthcare team but the duration should be as short as possible (expert opinion). The efficacy of beta-blockers and antiepileptics with mood regulation effects like carbamazepine and valproate yield the most compelling evidence and should be preferably used when a background regimen is envisioned (grade B for beta-blocker and C for antiepileptics). Neuroleptics, antidepressants, benzodiazepines, buspirone may be prescribed but are considered second-line treatments (expert opinion). Conclusion This study provides a strategy for treating the agitation crisis based on scientific data and expert opinion. The level of evidence remains low and published data are often old. New studies are essential to validate results from previous studies and test new drugs and non-pharmaceutical therapies. Permalink : ./index.php?lvl=notice_display&id=42785 [article] Care management of the agitation or aggressiveness crisis in patients with TBI. Systematic review of the literature and practice recommendations [texte imprimé] / Jacques Luauté ; David Plantier ; Laurent Wiart . - 2016 . - p.58-67. Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.58-67 Mots-clés : traumatisme cérébral  agitation  agressivité  comportement  recommandation Résumé : The agitation crisis in the awakening phase after traumatic brain injury (TBI) is one of the most difficult behavioral disorders to alleviate. Current treatment options are heterogeneous and may involve excessive sedation. Practice guidelines are required by professionals in charge of TBI patients. Few reviews were published but those are old and based on expert opinions. The purpose of this work is to propose evidence-based guidelines to treat the agitation crisis. Methods The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement. Guidelines were elaborated on the basis of a systematic and critical review of the literature. Results Twenty-eight articles concerning 376 patients were analyzed. Recommendations are: when faced with an agitation crisis, the management strategy implies to search for an underlying factor that should be treated such as pain, acute sepsis, and drug adverse effect (expert opinion). Physical restraints should be discarded when possible (expert opinion). Neuroleptic agent with a marketing authorization can be used in order to obtain a quick sedation so as to protect the patient from himself, closed ones or the healthcare team but the duration should be as short as possible (expert opinion). The efficacy of beta-blockers and antiepileptics with mood regulation effects like carbamazepine and valproate yield the most compelling evidence and should be preferably used when a background regimen is envisioned (grade B for beta-blocker and C for antiepileptics). Neuroleptics, antidepressants, benzodiazepines, buspirone may be prescribed but are considered second-line treatments (expert opinion). Conclusion This study provides a strategy for treating the agitation crisis based on scientific data and expert opinion. The level of evidence remains low and published data are often old. New studies are essential to validate results from previous studies and test new drugs and non-pharmaceutical therapies. Permalink : ./index.php?lvl=notice_display&id=42785

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Behavioral and affective disorders after brain injury: French guidelines for prevention and community supports / Jacques Luauté in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.68-73 Titre : Behavioral and affective disorders after brain injury: French guidelines for prevention and community supports Type de document : texte imprimé Auteurs : Jacques Luauté ; Jacques Hamonet ; Pascale Pradat-Diehl Année de publication : 2016 Article en page(s) : p.68-73 Langues : Anglais (eng) Mots-clés : traumatisme cérébral  trouble du comportement  trouble affectif Résumé : Objective The purpose of this study was to elaborate practice guidelines for the prevention of behavioral and affective disorders in adult outpatients after traumatic brain injury (TBI); but also to identify the support systems available for family, caregivers of patients with TBI within the community. Methods The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement. This involved a systematic and critical review of the literature looking for studies that investigated the impact of programs in community settings directed to behavioral and affective disorders post-TBI. Recommendations were than elaborated by a group of professionals and family representatives. Results Only six articles were found comprising 4 studies with a control group. Two studies showed a beneficial effect of personalized behavior management program delivered within natural community settings for persons with brain injury and their caregivers. Two other studies showed the relevance of scheduled telephone interventions to improve depressive symptoms and one study emphasized the usefulness of physical training. One study investigated the relevance of an outreach program; this study showed an improvement of the patients’ independence but did not yield any conclusions regarding anxiety and depression. Discussion and recommendations In addition to the application of care pathways already established by the SOFMER, prevention of behavioral and affective disorders for brain-injured outpatients should involve pain management, as well as development of therapeutic partnerships. It is recommended to inform patients, their family and caregivers regarding the local organization and facilities involved in the management of traumatic brain injury. The relevance of therapeutic education for implementing coping strategies, educating caregivers on behavioral disorder management, follow-up telephone interventions, and holistic therapy seems established. The level of evidence is low and preliminary studies should be confirmed with larger controlled trials. Permalink : ./index.php?lvl=notice_display&id=42788 [article] Behavioral and affective disorders after brain injury: French guidelines for prevention and community supports [texte imprimé] / Jacques Luauté ; Jacques Hamonet ; Pascale Pradat-Diehl . - 2016 . - p.68-73. Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.68-73 Mots-clés : traumatisme cérébral  trouble du comportement  trouble affectif Résumé : Objective The purpose of this study was to elaborate practice guidelines for the prevention of behavioral and affective disorders in adult outpatients after traumatic brain injury (TBI); but also to identify the support systems available for family, caregivers of patients with TBI within the community. Methods The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement. This involved a systematic and critical review of the literature looking for studies that investigated the impact of programs in community settings directed to behavioral and affective disorders post-TBI. Recommendations were than elaborated by a group of professionals and family representatives. Results Only six articles were found comprising 4 studies with a control group. Two studies showed a beneficial effect of personalized behavior management program delivered within natural community settings for persons with brain injury and their caregivers. Two other studies showed the relevance of scheduled telephone interventions to improve depressive symptoms and one study emphasized the usefulness of physical training. One study investigated the relevance of an outreach program; this study showed an improvement of the patients’ independence but did not yield any conclusions regarding anxiety and depression. Discussion and recommendations In addition to the application of care pathways already established by the SOFMER, prevention of behavioral and affective disorders for brain-injured outpatients should involve pain management, as well as development of therapeutic partnerships. It is recommended to inform patients, their family and caregivers regarding the local organization and facilities involved in the management of traumatic brain injury. The relevance of therapeutic education for implementing coping strategies, educating caregivers on behavioral disorder management, follow-up telephone interventions, and holistic therapy seems established. The level of evidence is low and preliminary studies should be confirmed with larger controlled trials. Permalink : ./index.php?lvl=notice_display&id=42788

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France establishes guidelines for treating neurobehavioral disorders following traumatic brain injury / Harvey Levin in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.74-77 Titre : France establishes guidelines for treating neurobehavioral disorders following traumatic brain injury Type de document : texte imprimé Auteurs : Harvey Levin Année de publication : 2016 Article en page(s) : p.74-77 Langues : Anglais (eng) Mots-clés : traumatisme cérébral  trouble comportement Résumé : This paper comments on the report by a committee of La Société Française de Médecine Physique et de Réadaptation (SOFMER) in response to the Haute Autorité de santé in France concerning the classification and clinical management of disorders of comportment following moderate to severe traumatic brain injury (TBI). In view of the large number of patients and families affected by these disorders, there is a strong rationale for these guidelines to ensure that clinical assessment and treatment is evidence-based. The report is viewed from the perspective of current research on disorders of comportment and in relation to recent reviews and meta-analyses on this topic. Comments on the classification draw on pathophysiology and brain imaging in addition to the clinical literature. The SOFMER report and recent projects in North America are compared for trends in the development of recommended assessment scales and standard, evidence-based treatment protocols for pharmacologic and non-pharmacologic interventions. Collaborative, multinational investigations of TBI are also noted, which are advancing progress toward guidelines for clinical management. Permalink : ./index.php?lvl=notice_display&id=42790 [article] France establishes guidelines for treating neurobehavioral disorders following traumatic brain injury [texte imprimé] / Harvey Levin . - 2016 . - p.74-77. Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.74-77 Mots-clés : traumatisme cérébral  trouble comportement Résumé : This paper comments on the report by a committee of La Société Française de Médecine Physique et de Réadaptation (SOFMER) in response to the Haute Autorité de santé in France concerning the classification and clinical management of disorders of comportment following moderate to severe traumatic brain injury (TBI). In view of the large number of patients and families affected by these disorders, there is a strong rationale for these guidelines to ensure that clinical assessment and treatment is evidence-based. The report is viewed from the perspective of current research on disorders of comportment and in relation to recent reviews and meta-analyses on this topic. Comments on the classification draw on pathophysiology and brain imaging in addition to the clinical literature. The SOFMER report and recent projects in North America are compared for trends in the development of recommended assessment scales and standard, evidence-based treatment protocols for pharmacologic and non-pharmacologic interventions. Collaborative, multinational investigations of TBI are also noted, which are advancing progress toward guidelines for clinical management. Permalink : ./index.php?lvl=notice_display&id=42790

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