title: The Relationship Between Postconcussive Symptoms and Quality of Life in Veterans With Mild to Moderate Traumatic Brain Injury.
abstract: OBJECTIVE
  To assess the relationship between postconcussive symptoms and quality of life (QOL) in Veterans with mild to moderate traumatic brain injury (TBI).
  
  
  METHODS
  Sixty-one Operation Enduring Freedom/Operation Iraqi Freedom/Persian Gulf War Veterans with a history of mild or moderate TBI, more than 6 months postinjury, and 21 demographically matched Veteran controls were administered self-report measures of QOL (World Health Organization Quality of Life-BREF) and postconcussive symptom severity (Neurobehavioral Symptom Inventory).
  
  
  RESULTS
  Perceived QOL was significantly worse in Veterans with mild-moderate TBI than in controls. In the TBI group, QOL was predominantly associated with affective symptoms, and moderate to strong correlations with fatigue and depression were evident across all QOL areas. Multivariate analyses revealed depression and fatigue to be the best predictors of Psychological, Social, and Environmental QOL, whereas sleep difficulty best predicted Physical QOL in mild-moderate TBI.
  
  
  CONCLUSIONS
  Veterans with post-acute mild-moderate TBI evidence worse QOL than demographically matched Veteran controls. Affective symptoms, and specifically those of fatigue, depression, and sleep difficulty, appear to be the most relevant postconcussive symptoms predicting QOL in this population. These findings underscore the importance of examining specific symptoms as they relate to post-acute TBI QOL and provide guidance for treatment and intervention studies.
authors.affiliation: VA San Diego Healthcare System (VASDHS), San Diego, California (Drs Schiehser, Twamley, Jak, Hanson, Delano-Wood, and Filoteo, and Ms Matevosyan); Departments of Psychiatry (Drs Schiehser, Twamley, Jak, Hanson, Delano-Wood, Filoteo and Orff) and Family and Preventive Medicine (Dr Liu), School of Medicine, University of California San Diego, La Jolla, California; Center of Excellence for Stress and Mental Health, VASDHS, San Diego, California (Drs Twamley, Jak, Hanson, Delano-Wood and Orff); and VA Puget Sound Health Care System, Seattle, Washington (Dr Sorg).
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Schiehser
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Twamley
authors.forename: Lin
authors.initials: L
authors.lastname: Liu
authors.forename: Adelina
authors.initials: A
authors.lastname: Matevosyan
authors.forename: J Vincent
authors.initials: JV
authors.lastname: Filoteo
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Jak
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Orff
authors.forename: Karen L
authors.initials: KL
authors.lastname: Hanson
authors.forename: Scott F
authors.initials: SF
authors.lastname: Sorg
authors.forename: Lisa
authors.initials: L
authors.lastname: Delano-Wood
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D038223:Post-Concussion Syndrome / Q000523:psychology*; D011788:Quality of Life; D057566:Self Report; D015599:Trauma Severity Indices; D014481:United States; D014728:Veterans; D055815:Young Adult