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Mild traumatic brain injury and posttraumatic stress disorder and their associations with health symptoms.
Arch Phys Med Rehabil. 2009 Jul; 90(7):1084-93.AP

Abstract

OBJECTIVE

To determine the association of various symptoms and psychiatric diagnoses with a remote history of mild traumatic brain injury (MTBI) and a current diagnosis of posttraumatic stress disorder (PTSD).

DESIGN

Cross-sectional cohort study.

SETTING

Nonclinical.

PARTICIPANTS

Three groups of randomly selected community dwelling male U.S. Army Vietnam-era veterans: healthy control (n=3218), those injured in a motor vehicle collision (MVC) but without a head injury (MVC injury control; n=548), and those who had an MTBI (n=278).

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Prevalence of psychiatric diagnoses, physical, cognitive, and emotional symptoms, and course of PTSD across time.

RESULTS

Logistic regression procedures were used to determine group association with symptoms and psychiatric diagnosis after controlling for demographic variables, combat intensity, medical disorders, and other current psychiatric conditions. MTBI was associated with headaches, memory problems, sleep problems, and fainting even after controlling for current psychiatric problems (including PTSD), as well as demographic variables, combat intensity, and comorbid medical conditions. MTBI also was associated with a current diagnosis of PTSD even controlling for other demographic, psychiatric, and medical covariates. MTBI did not moderate or mediate the relationship between PTSD and current symptomatology. However, MTBI did adversely affect long-term recovery from PTSD (odds ratio=1.59, 95% CI, 1.07-2.37). PTSD also was associated with physical, cognitive, and emotional symptoms, and had a larger effect size than MTBI.

CONCLUSIONS

MTBI, even in the chronic phase years postinjury, is not a benign condition. It is associated with increased rates of headaches, sleep problems, and memory difficulties. Furthermore, it can complicate or prolong recovery from preexisting or comorbid conditions such as PTSD. Similarly, PTSD is a potent cocontributor to physical, cognitive, and emotional symptoms.

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Authors+Show Affiliations

Vanderploeg RD
Department of Mental Health and Behavioral Sciences and Defense and Veterans Brain Injury Center, James A. Haley Veterans Affairs Medical Center, Tampa, FL 33612, USA. Rodney.Vanderploeg@va.gov
Belanger HG
No affiliation info available
Curtiss G
No affiliation info available

MeSH

AdultBrain InjuriesCohort StudiesCross-Sectional StudiesHealth StatusHumansMaleMental DisordersPost-Concussion SyndromePrevalenceRisk FactorsSeverity of Illness IndexSocioeconomic FactorsStress Disorders, Post-TraumaticUnited StatesVeterans

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

19577020

Citation

Vanderploeg, Rodney D., et al. "Mild Traumatic Brain Injury and Posttraumatic Stress Disorder and Their Associations With Health Symptoms." Archives of Physical Medicine and Rehabilitation, vol. 90, no. 7, 2009, pp. 1084-93.
Vanderploeg RD, Belanger HG, Curtiss G. Mild traumatic brain injury and posttraumatic stress disorder and their associations with health symptoms. Arch Phys Med Rehabil. 2009;90(7):1084-93.
Vanderploeg, R. D., Belanger, H. G., & Curtiss, G. (2009). Mild traumatic brain injury and posttraumatic stress disorder and their associations with health symptoms. Archives of Physical Medicine and Rehabilitation, 90(7), 1084-93. https://doi.org/10.1016/j.apmr.2009.01.023
Vanderploeg RD, Belanger HG, Curtiss G. Mild Traumatic Brain Injury and Posttraumatic Stress Disorder and Their Associations With Health Symptoms. Arch Phys Med Rehabil. 2009;90(7):1084-93. PubMed PMID: 19577020.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mild traumatic brain injury and posttraumatic stress disorder and their associations with health symptoms. AU - Vanderploeg,Rodney D, AU - Belanger,Heather G, AU - Curtiss,Glenn, PY - 2008/10/29/received PY - 2009/01/05/revised PY - 2009/01/20/accepted PY - 2009/7/7/entrez PY - 2009/7/7/pubmed PY - 2009/7/22/medline SP - 1084 EP - 93 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 90 IS - 7 N2 - OBJECTIVE: To determine the association of various symptoms and psychiatric diagnoses with a remote history of mild traumatic brain injury (MTBI) and a current diagnosis of posttraumatic stress disorder (PTSD). DESIGN: Cross-sectional cohort study. SETTING: Nonclinical. PARTICIPANTS: Three groups of randomly selected community dwelling male U.S. Army Vietnam-era veterans: healthy control (n=3218), those injured in a motor vehicle collision (MVC) but without a head injury (MVC injury control; n=548), and those who had an MTBI (n=278). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Prevalence of psychiatric diagnoses, physical, cognitive, and emotional symptoms, and course of PTSD across time. RESULTS: Logistic regression procedures were used to determine group association with symptoms and psychiatric diagnosis after controlling for demographic variables, combat intensity, medical disorders, and other current psychiatric conditions. MTBI was associated with headaches, memory problems, sleep problems, and fainting even after controlling for current psychiatric problems (including PTSD), as well as demographic variables, combat intensity, and comorbid medical conditions. MTBI also was associated with a current diagnosis of PTSD even controlling for other demographic, psychiatric, and medical covariates. MTBI did not moderate or mediate the relationship between PTSD and current symptomatology. However, MTBI did adversely affect long-term recovery from PTSD (odds ratio=1.59, 95% CI, 1.07-2.37). PTSD also was associated with physical, cognitive, and emotional symptoms, and had a larger effect size than MTBI. CONCLUSIONS: MTBI, even in the chronic phase years postinjury, is not a benign condition. It is associated with increased rates of headaches, sleep problems, and memory difficulties. Furthermore, it can complicate or prolong recovery from preexisting or comorbid conditions such as PTSD. Similarly, PTSD is a potent cocontributor to physical, cognitive, and emotional symptoms. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/19577020/Mild_traumatic_brain_injury_and_posttraumatic_stress_disorder_and_their_associations_with_health_symptoms_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(09)00268-8 DB - PRIME DP - Unbound Medicine ER -