Article

Psychiatric diagnoses among Iraq and Afghanistan War veterans screened for deployment-related traumatic brain injury

Center for Chronic Disease Outcomes Research, VA Medical Center, and Department of Medicine, University of Minnesota Medical School, Minneapolis, MN 55417, USA.
Journal of Traumatic Stress (Impact Factor: 2.72). 02/2010; 23(1):17-24. DOI: 10.1002/jts.20483
Source: PubMed

ABSTRACT

The authors examined psychiatric diagnoses in administrative records for 13,201 United States military veterans who were screened for traumatic brain injury (TBI) in Department of Veterans Affairs facilities. Over 80% of the veterans with positive TBI screens had psychiatric diagnoses. Compared to veterans with negative TBI screens, those with positive screens, but without confirmed TBI status, were three times more likely to have a posttraumatic stress disorder (PTSD) diagnosis and were two times more likely to have depression and substance-related diagnoses. Among veterans with positive TBI screens, those with clinically confirmed TBI status were more likely than those without confirmed TBI status to have diagnoses for PTSD, anxiety, and adjustment disorders. These findings have implications for health care delivery and provider education.

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    • "However, some studies have found post-traumatic stress disorder (PTSD) to account for the relationship (Miles et al., 2015;Polusny et al., 2011), while others have found a significant association persists when PTSD is accounted for. Analysis of over 13,000 soldiers who had served in Iraq and/or Afghanistan, indicated that soldiers who had experienced a confirmed TBI during active duty were nearly 3 times as likely to present with a substance abuse problem (Carlson et al., 2010). Similarly, among more than 4,000 British soldiers returning from Afghanistan and/or Iraq, those that experienced a TBI were 2.3 times as likely to report alcohol misuse (Rona et al., 2012). "
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    • "The symptoms shared among mild TBI, PTSD and depression include, for example , headache, insomnia, fatigue, irritability, cognitive dysfunction , and chronic pain (Hoge et al. 2008; Iverson 2005), all which can be considered independently existing clinical processes or as components of a complex syndrome (Scholten et al. 2012). These symptoms and conditions also frequently co-occur, which further complicates clinical understanding and may ultimately impede treatment and recovery (Carlson et al. 2010, 2011; Hill et al. 2009; Schneiderman et al. 2008; Vanderploeg et al. 2012; Vanderploeg 2007; Walker et al. 2012). Despite the complex comorbidity of these conditions, the current clinical practice guideline for treatment of mild TBI (concussion) calls for single disease focused treatment and symptom-based management (Management of Concussion/ mTBI Working Group 2009). "
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    • "After experiencing mTBI, soldiers typically return to full duty status immediately after clinical signs begin to disappear, but returning prematurely can increase the risk for repeat injury (MacGregor et al., 2011). Previous studies have shown that mTBI patients experience complications associated with post-concussive syndrome (PCS) (Schneiderman et al., 2008; Belanger et al., 2010; Bryant et al., 2010) or post-traumatic stress disorder (PTSD) (Hoge et al., 2008; Carlson et al., 2010; Levin et al., 2010; Carlson et al., 2011). The underlying mechanisms of these symptoms warrants further investigation and has significant clinical implications (Budde et al., 2011). "
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