Psychiatric hospitalization and veterans with traumatic brain injury: a retrospective study.
OBJECTIVE
To determine risk factors for psychiatric hospitalization after traumatic brain injury (TBI) in veterans. SUBJECTS AND PROCEDURES: Medical records of 96 veterans with histories of TBI (17 mild, 33 moderate, and 46 severe) were reviewed for information concerning psychiatric history, including hospitalization and substance misuse.


RESULTS
Subjects with a history of problematic drug and alcohol use had a significantly higher probability of psychiatric hospitalization than those without such a history. Gender, age, problematic alcohol use without problematic drug use, injury severity, time since injury, years of follow-up, and a history of psychiatric symptoms (including those attributed to general medical conditions) were not identified as significant risk factors. Ninety-one veterans (95%) had a history of psychiatric difficulty. In addition, the probability of post-TBI problematic drug and alcohol use, given a pre-TBI history of such use, was significantly higher than the probability given no history.


CONCLUSIONS
Veterans with problematic drug and alcohol use are at increased risk for psychiatric hospitalization after TBI. In addition, the likelihood of problematic post-TBI drug and alcohol use was significantly greater for those with a preinjury history. Ninety-five percent of veterans in the current sample endorsed lifetime histories of psychiatric difficulty. These findings highlight the need for evidence-based means of psychiatric and/or substance abuse treatment of those with a history of TBI.
Brenner
Lisa A
LA
VA VISN 19 Mental Illness Research, Education and Clinical Center, Denver, CO 80220, USA. Lisa.Brenner@va.gov
Harwood
Jeri E F
JE
Homaifar
Beeta Y
BY
Cawthra
Ellen
E
Waldman
Jeffrey
J
Adler
Lawrence E
LE
D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012306:Risk; D019966:Substance-Related Disorders / Q000209:etiology*; D014728:Veterans; D055815:Young Adult