Mood and Cognition after Electrical Injury: A Follow-up Study
D. M. Aase; J. W. Fink; R. C. Lee; K. M. Kelley; N. H. Pliskin
Archives of Clinical Neuropsychology 2014
Survivors of electrical injury (EI) often report physical, cognitive and psychological changes. Previous research has shown that EI patients undergo more physical and psychological distress than patients who suffer other traumatic experiences. Prior research exploring psychiatric and cognitive sequelae within the EI patient population has shown that increased depressive symptoms were associated with poorer performance on cognitive measures.
Previously conducted studies have suggested that psychiatric and cognitive disturbances can intensify with time in EI patients. However, these conclusions are limited as the studies either relied on self-reported measures or did not conduct a prospective follow-up. Understanding the association between psychiatric symptoms and cognitive functions over time can help physicians develop better treatment practices for EI patients.
In this study, 20 EI patients who had been assessed by the Chicago Electrical Trauma Research Institute (CETRI) were selected from a pool of 203 potential participants. These participants were selected as they had also completed a follow-up neuropsychological evaluation with CETRI. The patients were assessed an average of 1 year after their electrical injury and re-examined approximately 23 months later. Neuropsychological evaluation was done by testing simple and complex attention by using the Trail Making Test, the Stroop Color and Word Test. BDI and BDII were used to test mood symptoms. A change score was calculated to measure the change in mood symptoms over time.
In the overall sample, there was little change over time from low average to average cognitive outcome measures. However, the results indicated that increases in depressive symptoms over time were consistently associated with poorer performance in tests measuring simple and complex attention. For at least a subset of EI patients, the presence of psychiatric symptoms that occur shortly after the injury appear to have a detrimental effect on some areas of cognitive functioning. Loss of consciousness, litigation status, acute vs. post-acute injury and time between evaluations did not have a significant influence on the changes in cognitive performance.
The study shows that early screening and treatment of psychiatric conditions can help reduce or prevent a decline in cognitive function that may occur shortly after the electrical injury. This paper is one of the few studies that evaluates the relationship between mood and cognitive variables in EI patients over time.