Mild Traumatic Brain Injury (Concussion), Posttraumatic Stress Disorder, and Depression in U.S. Soldiers Involved in Combat Deployments

Abstract

These data indicate that current screening tools for mTBI being used by the Department of Defense/Veteran's Affairs do not optimally distinguish persistent postdeployment symptoms attributed to mTBI from other causes such as PTSD and depression. Accumulating evidence strongly supports the need for multidisciplinary collaborative care models of treatment in primary care to collectively address the full spectrum of postwar physical and neurocognitive health concerns.

Interdisciplinary Residential Treatment of Posttraumatic Stress Disorder and Traumatic Brain Injury: Effects on Symptom Severity and Occupational Performance and Satisfaction

“…Even more optimal than referral is integrated assessment and treatment with open communication among multiple disciplines when providing care to veterans with PTSD, MDD, and a history of TBI. These associations support the interdisciplinary treatment model and previous recommendations to make functional improvement a greater priority than treatment of individual symptoms (Wilk et al, 2012).…”

“…Because of symptom overlap, the interaction among PTSD, MDD, and a history of TBI is complicated and not fully understood, making overall functional improvement perhaps a greater priority than specialty treatment of individual symptoms (Wilk, Herrell, Wynn, Riviere, & Hoge, 2012). Providing the most comprehensive evidencebased care in the treatment of these combined conditions requires collaboration among disciplines, which preliminary research has suggested improves outcomes for people with chronic conditions (Hand, Letts, & von Zweck, 2011).…”

“…The complex needs of veterans who have experienced symptoms resulting from PTSD, a history of TBI, and other comorbid conditions (e.g., MDD) may be most successfully addressed through a collaborative approach to care within a structured environment designed to facilitate learning of new skills, development of healthy habits, and performance in healthy occupational areas and skills (e.g., Wilk et al, 2012). The current study had three primary aims: (1) to evaluate outcomes of an interdisciplinary residential treatment program in terms of occupational performance and satisfaction with self-identified important problematic occupational areas, (2) to examine the effects of an interdisciplinary residential treatment program on PTSD and depression symptom severity, and (3) to evaluate whether improvements in occupational performance and satisfaction were related to decreases in PTSD and depression symptom severity.…”

Randomized Placebo-Controlled Trial of Methylphenidate or Galantamine for Persistent Emotional and Cognitive Symptoms Associated with PTSD and/or Traumatic Brain Injury

“…Moreover, there is a high level of co-occurrence of TBI and PTSD in this population. Many observational studies from both military and civilian settings (Hoge et al, 2008;Schneiderman et al, 2008) have firmly established an association between mTBI and PTSD (Hoge et al, 2008;Schneiderman et al, 2008;Carlson et al, 2011;Hart et al, 2014;Stein and McAllister, 2009;Tanev et al, 2014;Wilk et al, 2012;Wisco et al, 2014;Yurgil et al, 2014). These observations signal not only a need for effective interventions for PTSD and mTBI occurring individually, but for interventions that have the potential to address both conditions at the same time.…”

Common biochemical defects linkage between post-traumatic stress disorders, mild traumatic brain injury (TBI) and penetrating TBI

“…Mild brain concussive injury can cause cognitive and emotional dysfunction and increase the risk for the development of anxiety disorders, including PTSD (Carlson et al, 2011, Wilk et al, 2012. The N-methyl-D-aspartate (NMDA) glutamate receptors in the amygdala appear to regulate fear and anxiety.…”