title: PTSD and TBI co-morbidity: scope, clinical presentation and treatment options.
abstract: OBJECTIVE
  To summarize the literature on post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) and their co-morbidity, focusing on diagnosis, clinical symptoms and treatment issues relevant to the clinician.
  
  
  METHODS
  Review of the literature.
  
  
  METHODS
  Pubmed searches were performed using the terms post-traumatic stress disorder, traumatic brain injury, sleep, cognitive, depression, anxiety, treatment and combinations of these terms. Those articles relevant to the objective were included.
  
  
  RESULTS
  This study presents pathophysiological, neuroimaging and clinical data on co-morbid PTSD and TBI. It reviews associated conditions, emphasizing the impact of cognitive and sleep problems. It summarizes the emerging literature on treatment effectiveness for co-morbid PTSD and TBI, including psychotherapy, pharmacotherapy and cognitive rehabilitation.
  
  
  CONCLUSIONS
  Both PTSD and TBI commonly occur in the general population, both share some pathophysiological characteristics and both are associated with cognitive impairment and sleep disruption. PTSD and TBI present with a number of overlapping symptoms, which can lead to over-diagnosis or misdiagnosis. Both conditions are associated with co-morbidities important in diagnosis and treatment planning. More research is needed to elucidate what treatments are effective in PTSD and TBI co-morbidity and on factors predictive of treatment success.
authors.affiliation: Massachusetts General Hospital , Department of Psychiatry, The Home Base Program, Boston, MA , USA and.
authors.forename: Kaloyan S
authors.initials: KS
authors.lastname: Tanev
authors.forename: Kimberly Z
authors.initials: KZ
authors.lastname: Pentel
authors.forename: Maria A
authors.initials: MA
authors.lastname: Kredlow
authors.forename: Meredith E
authors.initials: ME
authors.lastname: Charney
mesh_terms: D001930:Brain Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003130:Combat Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D015897:Comorbidity; D003937:Diagnosis, Differential; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data; D009473:Neuronal Plasticity; D015398:Signal Transduction; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States
chemical_list: D019208:Brain-Derived Neurotrophic Factor