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Association between mild traumatic brain injury and mental health problems and self-reported cognitive dysfunction in Iraq and Afghanistan Veterans.
J Rehabil Res Dev. 2016; 53(2):185-98.JR

Abstract

The Department of Veterans Affairs traumatic brain injury (TBI) screening program is intended to detect and expedite treatment for TBI and postconcussive symptoms. Between April 14, 2007, and May 31, 2012, of 66,089 Iraq and Afghanistan Veterans who screened positive on first-level TBI screening and later completed comprehensive TBI evaluation that includes the Neurobehavioral Symptoms Inventory, 72% reported moderate to very severe cognitive impairment (problems with attention, concentration, memory, etc.) that interfered with daily activities. This included 42% who were found not to have sustained combat-related mild TBI (mTBI). In contrast, 70.0% received a posttraumatic stress disorder (PTSD) diagnosis and 45.8% received a depression diagnosis. Compared with Veterans without mTBI, PTSD, or depression diagnoses, the lowest risk for self-reported cognitive impairment was in Veterans with confirmed mTBI only; a greater risk was found in those with PTSD diagnoses, with the greatest risk in Veterans with PTSD, depression, and confirmed mTBI, suggesting only a weakly additive effect of mTBI. These findings suggest that Veterans with multiple mental health comorbidities, not just those with TBI, report moderate to very severe cognitive impairment. Mental health treatment for conditions such as PTSD and depression (with or without TBI) may result in improvements in cognitive functioning and/or include assessment and support for Veterans experiencing cognitive problems.

Authors+Show Affiliations

San Francisco Department of Veterans Affairs (VA) Health Care System, San Francisco, CA;No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

27148692

Citation

Seal, Karen H., et al. "Association Between Mild Traumatic Brain Injury and Mental Health Problems and Self-reported Cognitive Dysfunction in Iraq and Afghanistan Veterans." Journal of Rehabilitation Research and Development, vol. 53, no. 2, 2016, pp. 185-98.
Seal KH, Bertenthal D, Samuelson K, et al. Association between mild traumatic brain injury and mental health problems and self-reported cognitive dysfunction in Iraq and Afghanistan Veterans. J Rehabil Res Dev. 2016;53(2):185-98.
Seal, K. H., Bertenthal, D., Samuelson, K., Maguen, S., Kumar, S., & Vasterling, J. J. (2016). Association between mild traumatic brain injury and mental health problems and self-reported cognitive dysfunction in Iraq and Afghanistan Veterans. Journal of Rehabilitation Research and Development, 53(2), 185-98. https://doi.org/10.1682/JRRD.2014.12.0301
Seal KH, et al. Association Between Mild Traumatic Brain Injury and Mental Health Problems and Self-reported Cognitive Dysfunction in Iraq and Afghanistan Veterans. J Rehabil Res Dev. 2016;53(2):185-98. PubMed PMID: 27148692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between mild traumatic brain injury and mental health problems and self-reported cognitive dysfunction in Iraq and Afghanistan Veterans. AU - Seal,Karen H, AU - Bertenthal,Daniel, AU - Samuelson,Kristin, AU - Maguen,Shira, AU - Kumar,Sant, AU - Vasterling,Jennifer J, PY - 2014/12/01/received PY - 2015/06/25/revised PY - 2016/5/6/entrez PY - 2016/5/7/pubmed PY - 2018/1/18/medline KW - Veterans KW - cognitive dysfunction KW - concussion KW - depression KW - mental health KW - mild traumatic brain injury KW - population-based screening KW - postdeployment KW - posttraumatic stress disorder KW - primary care KW - recovery expectations SP - 185 EP - 98 JF - Journal of rehabilitation research and development JO - J Rehabil Res Dev VL - 53 IS - 2 N2 - The Department of Veterans Affairs traumatic brain injury (TBI) screening program is intended to detect and expedite treatment for TBI and postconcussive symptoms. Between April 14, 2007, and May 31, 2012, of 66,089 Iraq and Afghanistan Veterans who screened positive on first-level TBI screening and later completed comprehensive TBI evaluation that includes the Neurobehavioral Symptoms Inventory, 72% reported moderate to very severe cognitive impairment (problems with attention, concentration, memory, etc.) that interfered with daily activities. This included 42% who were found not to have sustained combat-related mild TBI (mTBI). In contrast, 70.0% received a posttraumatic stress disorder (PTSD) diagnosis and 45.8% received a depression diagnosis. Compared with Veterans without mTBI, PTSD, or depression diagnoses, the lowest risk for self-reported cognitive impairment was in Veterans with confirmed mTBI only; a greater risk was found in those with PTSD diagnoses, with the greatest risk in Veterans with PTSD, depression, and confirmed mTBI, suggesting only a weakly additive effect of mTBI. These findings suggest that Veterans with multiple mental health comorbidities, not just those with TBI, report moderate to very severe cognitive impairment. Mental health treatment for conditions such as PTSD and depression (with or without TBI) may result in improvements in cognitive functioning and/or include assessment and support for Veterans experiencing cognitive problems. SN - 1938-1352 UR - https://www.unboundmedicine.com/medline/citation/27148692/Association_between_mild_traumatic_brain_injury_and_mental_health_problems_and_self_reported_cognitive_dysfunction_in_Iraq_and_Afghanistan_Veterans_ L2 - https://www.rehab.research.va.gov/jour/2016/532/pdf/JRRD-2014-12-0301.pdf DB - PRIME DP - Unbound Medicine ER -