title: Prevalence of mental health conditions after military blast exposure, their co-occurrence, and their relation to mild traumatic brain injury.
abstract: OBJECTIVE
  To measure common psychiatric conditions after military deployment with blast exposure and test relationships to post-concussion syndrome (PCS) symptoms and mild traumatic brain injury (mTBI) history.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Service members or Veterans (n = 107) within 2 years of blast exposure underwent structured interviews for mTBI, post-traumatic stress disorder (PTSD) and multiple mood and anxiety diagnoses.
  
  
  RESULTS
  MTBI history and active PTSD were both common, additionally 61% had at least one post-deployment mood or anxiety disorder episode. Psychiatric diagnoses had a high degree of comorbidity. Most dramatically, depression was 43-times (95% CI = 11-165) more likely if an individual had PTSD. PCS symptoms were greater in those with post-deployment PTSD or mood diagnosis. However, neither mTBI nor blast exposure history had an effect on the odds of having PTSD, mood or anxiety condition.
  
  
  CONCLUSIONS
  These findings support that psychiatric conditions beyond PTSD are common after military combat deployment with blast exposure. They also highlight the non-specificity of post-concussion type symptoms. While some researchers have implicated mTBI history as a contributor to post-deployment mental health conditions, no clear association was found. This may partly be due to the more rigorous method of retrospective mTBI diagnosis determination.
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Virginia Commonwealth University, School of Medicine , Richmond , VA , USA .|b Defense and Veterans Brain Injury Center , Richmond , VA , USA .|c Hunter Holmes McGuire Veterans Affairs Medical Center , Richmond , VA , USA .
authors.forename: W C
authors.initials: WC
authors.lastname: Walker
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Virginia Commonwealth University, School of Medicine , Richmond , VA , USA .|b Defense and Veterans Brain Injury Center , Richmond , VA , USA .|c Hunter Holmes McGuire Veterans Affairs Medical Center , Richmond , VA , USA .
authors.forename: L M
authors.initials: LM
authors.lastname: Franke
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Virginia Commonwealth University, School of Medicine , Richmond , VA , USA .|c Hunter Holmes McGuire Veterans Affairs Medical Center , Richmond , VA , USA .|d Department of Psychology , Virginia Commonwealth University , USA .
authors.forename: S D
authors.initials: SD
authors.lastname: McDonald
authors.affiliation: e Department of Biostatistics , Virginia Commonwealth University , USA , and.
authors.forename: A P
authors.initials: AP
authors.lastname: Sima
authors.affiliation: f Department of Psychiatry , Virginia Commonwealth University , Richmond , VA , USA.
authors.forename: L
authors.initials: L
authors.lastname: Keyser-Marcus
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000453:epidemiology* / Q000523:psychology; D001930:Brain Injuries / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D009483:Neuropsychological Tests; D038223:Post-Concussion Syndrome / Q000523:psychology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Mood disorders; anxiety disorders; concussion; explosive blast; post-traumatic stress disorder; traumatic brain injury