Traumatic brain injury, posttraumatic stress disorder, and postconcussive symptom reporting among troops returning from iraq.
OBJECTIVE
Analyze the contribution of mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD) to the endorsement of postconcussive (PC) symptoms during Post Deployment Health Assessment. Determine whether a combination of mTBI and PTSD was more strongly associated with symptoms than either condition alone.


METHODS
Cross-sectional study design where both the exposure, mTBI and/or PTSD, and the outcomes of interest, PC symptoms, were ascertained after return from deployment. Subjects were injured soldiers (n = 1247) from one Fort Carson Brigade Combat Team (n = 3973).


METHODS
Positive history of PC symptoms.


RESULTS
PTSD and mTBI together were more strongly associated with having PC symptoms (adjusted prevalence ratio 6.27; 95% CI: 4.13-9.43) than either mTBI alone (adjusted prevalence ratio = 4.03; 95% CI: 2.67-6.07) or PTSD alone (adjusted prevalence ratio = 2.74; 95% CI: 1.58-4.74) after adjusting for age, gender, education, rank, and Military Occupational Specialty.


CONCLUSIONS
In soldiers with histories of physical injury, mTBI and PTSD were independently associated with PC symptom reporting. Those with both conditions were at greater risk for PC symptoms than those with either PTSD, mTBI, or neither. Findings support the importance of continued screening for both conditions with the aim of early identification and intervention.
Brenner
Lisa A
LA
VA VISN 19 Mental Illness Research Education and Clinical Center, Denver, Colorado, USA. lisa.brenner@va.gov
Ivins
Brian J
BJ
Schwab
Karen
K
Warden
Deborah
D
Nelson
Lonnie A
LA
Jaffee
Michael
M
Terrio
Heidi
H
D000293:Adolescent; D000328:Adult; D001753:Blast Injuries / Q000150:complications / Q000453:epidemiology*; D001930:Brain Injuries / Q000150:complications / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D038223:Post-Concussion Syndrome / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult