No abstract

Blast injury is common in current warfare, but little is known about the effects of blast-related mild traumatic brain injury (mTBI). Profi le analyses were conducted investigating differences in self-reported postconcussive (PC) symptoms in 339 veteran outpatients with mTBI histories reporting current symptoms based on mechanism of injury (blast only, nonblast only, or both blast and nonblast), number of blast injuries, and distance from the blast. Veterans with any blast-related mTBI history were younger and reported higher posttraumatic stress symptoms than veterans with nonblast-related mTBI histories, with a marginally signifi cant difference in posttraumatic stress symptom report between veterans reporting blast-related mTBI only and those reporting nonblast-related mTBI. The groups did not differ in terms of PC symptom severity or PC symptom cluster profi les. Among veterans with blast-related mTBI histories, PC symptom report did not vary by number of blast-related mTBIs or proximity to blast. Overall, posttraumatic stress symptoms accounted for a substantial portion of variance in PC symptom report. In veteran outpatients with remote mTBI histories who have enduring symptom complaints related to the mTBI, mechanism of injury did not clearly contribute to differential PC symptom severity or PC symptom cluster profi le. Proximal rather than distal factors may be important intervention targets in returning symptomatic veterans with mTBI histories. ( JINS , 2010, 16 , 856-866 .)

PTS is an important variable to account for when evaluating PCSx in veterans. Research and clinical implications for the measurement and interpretation of self-reported PCSx are discussed.

In the past few years, synthetic cannabinoid products have been increasingly used by adolescents and young adults. These products are marketed as herbal or aromatic incense and potpourri, but their psychoactive properties appear to be due to the addition of synthetic cannabinoids. When smoked, they can produce significant psychoactive and physical effects similar to cannabis. Changes in cognition, behavioral disturbances, alterations in mood, and perceptual changes have been reported. An emerging body of literature indicates that use of these products is associated with anxiety and other negative mood changes not typical of cannabis intoxication. Use of synthetic cannabinoid products has been associated with new onset psychosis or exacerbation of pre-existing psychosis, although current evidence cannot establish a definitive link between synthetic cannabinoids and psychosis. Clinicians should suspect synthetic cannabinoid product use if a patient: 1) presents with signs and symptoms consistent with cannabis use, 2) has negative routine urine toxicology screens, 3) is in a situation in which his or her urine is being routinely monitored for illicit substance use, and/or 4) presents with otherwise unexplained sudden onset psychosis. To make the diagnosis, clinicians should become familiar with the effects of synthetic cannabinoid use and have a high index of suspicion.