Psychosexual and psychosocial sequelae of closed head injury

Abstract

A series of 36 patients who had been hospitalized following closed head injury (CHI) were followed up 4.06 (SD 3.71) years after the injury. Measures were taken of degree of psychosexual dysfunction (Golombok Rust Inventory of Sexual Satisfaction-GRISS), general psychiatric morbidity (General Health Questionnaire-GHQ), and clinical anxiety and depression (Hospital Anxiety and Depression Scale-HAD). These measures were completed by patients and partners. Resulting data revealed that 50% of male patients with current sexual partners produced psychosexual profiles that fell within the dysfunctional range. For both male patients and their partners, the chief psychosexual complaint was infrequency. Of the patients studied, 61% were classified (using the GHQ) as having degrees of emotional distress that would fall within the range of psychiatric 'caseness', while 25% of patients achieved HAD criteria for clinical anxiety and 22% met HAD criteria for depression. Of the partners, 41% met GHQ criteria for psychiatric 'caseness', 18% being classified using the HAD as anxiety cases and 6% as depression cases. No effects of severity of injury were observed on any of the main outcome measures. Age and time since injury were related to measures of psychosexual dysfunction. These results are discussed in relation to the existing literature on psychosocial outcome in closed head injury, and recommendations for therapeutic intervention are made.

Relating Quality of Life to Glasgow Outcome Scale Health States

“…The annual direct and indirect monetary burden of TBI on the United States was estimated at $60 billion in 2000 (Finkelstein et al, 2006). Survivors of TBI have a reduced QOL, as assessed by multiple scales, including the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), the Sickness Impact Profile and the General Health Questionnaire, the Life Satisfaction Inventory, and the newlydeveloped Quality of Life in TBI or QOLIBRI scale (Colantonio et al, 1998;Corrigan et al, 1998;Findler et al, 2001;Guilfoyle et al, 2010;Kinsella et al, 1989;Kreuter et al, 1998;O'Carroll et al, 1991;Paniak et al, 1999;Resch et al, 2009;Temkin et al 1988;Truelle et al, 2010). There has been a call for increased utilization of CER to improve these statistics, though such studies in the TBI field have heretofore been limited due to the lack of QOL values for comparing intermediate outcomes as described by the GOSE.…”

Masculine role adherence and outcomes among men with traumatic brain injury

“…Numerous studies have found erectile dysfunction to be common among men with TBI [14,[25][26][27]. Other frequent difficulties include decreased frequency of sexual activity [14,28] and loss of sexual desire [29,30]. In a review of the literature on sexual functioning following TBI, Aloni and Katz [24] outlined that sexual difficulties following TBI can be attributed to both primary and secondary dysfunction.…”

Talking about sex after traumatic brain injury: perceptions and experiences of multidisciplinary rehabilitation professionals

“…More formal findings have indicated that 50-60% of people report some level of disruption to sexual function post-TBI [7][8][9][10]. The reasons for changes in sexuality are complex and multifaceted, but TBI has the potential to disrupt social and relationship skills, body image and self-esteem, behavioural control, libido and the physical capacity to perform sexually [9][10][11][12][13].…”