Article

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.
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Langue : ANGLAIS