title: Long-Term Neurobehavioral Symptoms and Return to Productivity in Operation Enduring Freedom/Operation Iraqi Freedom Veterans With and Without Traumatic Brain Injury.
abstract: To describe Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans who underwent the Comprehensive Traumatic Brain Injury Evaluation (CTBIE), differences between the traumatic brain injury (TBI) and non-TBI subgroups, and factors associated with return to productivity (RTP).
  
  
  
  Retrospective medical record review.
  
  
  
  Medical center.
  
  
  
  Medical records of OEF/OIF veterans (N=236) who underwent the CTBIE between 2009 and 2013.
  
  
  
  Not applicable.
  
  
  
  Demographic characteristics, injury history, clinical presentation, and factors associated with RTP.
  
  
  
  Veteran sample included 90.7% men, was 45.3% white and 34.7% black, with half of Hispanic origin, and had a mean age of 33 years. The mean time since injury was approximately 4 years. Reported symptoms were high, with >90% reporting anxiousness, irritability, sleep difficulty, forgetfulness, and headaches. TBI diagnosis was found in 163 veterans (69%). The TBI subgroup was younger (TBI: 32.5y vs non-TBI: 34.9y; P=.02), reported a greater number of injuries (P<.001), and had significantly higher rates of half of the reported symptoms. Greatest differences were noted with forgetfulness (TBI: 95.7% vs non-TBI: 79.5%; P<.001), poor concentration (TBI: 90.2% vs non-TBI: 76.7%; P=.007), and headaches (TBI: 93.9% vs non-TBI: 83.6%; P=.014). RTP was 60.6% for the total veteran population. Factors associated with RTP were race (white) (odds ratio [OR], 2.00; 95% confidence interval [CI], 1.13-3.55; P=.018), sensitivity to light (OR, 2.58; 95% CI, 1.17-5.66; P=.018), and fatigue (OR, 3.68; 95% CI, 1.51-8.95; P=.004). Veterans that did RTP were 3 times less likely to report depression (OR, .32; 95% CI, .12-.85; P=.022).
  
  
  
  Veterans reported a substantial number of lingering symptoms, with a higher prevalence in veterans with TBI. Veterans with reported depression were less likely to RTP. Future research should focus on the relation between depression and non-RTP and the effectiveness of Department of Veterans Affairs services.
authors.affiliation: Department of Rehabilitation Medicine, James J. Peters Veterans Affairs Medical Center, Bronx, NY.
authors.forename: Marianne H
authors.initials: MH
authors.lastname: Mortera
authors.affiliation: Department of Rehabilitation Medicine, James J. Peters Veterans Affairs Medical Center, Bronx, NY; Program in Physical Therapy, Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, NY. Electronic address: sak2113@cumc.columbia.edu.
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Kinirons
authors.affiliation: Department of Rehabilitation Medicine, James J. Peters Veterans Affairs Medical Center, Bronx, NY.
authors.forename: Jessie
authors.initials: J
authors.lastname: Simantov
authors.affiliation: Department of Rehabilitation Medicine, James J. Peters Veterans Affairs Medical Center, Bronx, NY.
authors.forename: Heidi
authors.initials: H
authors.lastname: Klingbeil
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000070642:Brain Injuries, Traumatic / Q000523:psychology*; D003863:Depression / Q000523:psychology; D004526:Efficiency; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D062707:Return to Work / Q000523:psychology / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States; D014728:Veterans / Q000523:psychology*; D000067398:War-Related Injuries / Q000523:psychology*
keywords: Brain injuries, traumatic; Military personnel; Rehabilitation; Veterans