Psychiatric Comorbidity and Psychosocial Problems Among Treatment-Seeking Veterans With a History of Mild Traumatic Brain Injury.

Focus (Am Psychiatr Publ)

Dr. Wojtowicz is with the Department of Psychology, York University, Toronto, Canada. She was with the Departments of Psychiatry and Physical Medicine and Rehabilitation, Harvard Medical School, Boston, and Home Base, a Red Sox Foundation and Massachusetts General Hospital program, Boston, at the time this work was completed. Dr. Silverberg is with GF Strong Rehab Centre and the Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada; and Home Base. Drs. Bui and Simon are with the Department of Psychiatry, Harvard Medical School, and Home Base. Dr. Zafonte is with the Department of Physical Medicine and Rehabilitation, Harvard Medical School; is Chief of Physical Medicine and Rehabilitation at Spaulding Rehabilitation Hospital, Massachusetts General Hospital, and Brigham and Women's Hospital, Boston; and is with Home Base. Dr. Iverson is with the Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; and Home Base.

Published: October 2017

Mild traumatic brain injuries (MTBIs) are common in sports, military service, and daily life. Limited data are available on the mental health needs of veterans with a history of MTBI who are seeking care in the community. The purpose of this article is to describe the mental health and psychosocial difficulties of a group of treatment-seeking veterans with a history of MTBI. The authors examined psychiatric comorbidities, psychosocial problems, and symptom burden in a cross-sectional sample of 129 treatment-seeking post-9/11 U.S. service members and veterans who reported a history of MTBI during a mental health evaluation at a nonprofit specialty outpatient clinic. The most common clinician-rated comorbid psychiatric diagnoses included posttraumatic stress disorder (N=113; 88%), major depressive disorder (N=57; 44%), alcohol use or abuse (N=56; 43%), and substance use or abuse (N=28; 22%). In addition, these service members and veterans endorsed high rates of anger and aggression, hazardous drinking, bodily pain, sleep difficulties, concentration problems, unemployment, and difficulties with family functioning. These clinical data suggest that post-9/11 service members and veterans who present with a history of MTBI represent a group of people who are highly symptomatic, have multiple comorbid conditions, and are struggling with multiple psychiatric, behavioral, and psychosocial difficulties. Clinical services designed to evaluate and treat these veterans should consider careful integration of mental health screening and services.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519526PMC
http://dx.doi.org/10.1176/appi.focus.20170028DOI Listing

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