Department of Veteran's Affairs Office of Rehabilitation Services, Washington, District of Columbia, USA.
J Head Trauma Rehabil. 2012 Jul-Aug;27(4):253-60. doi: 10.1097/HTR.0b013e3182585cd5.
The co-occurrence of psychiatric disorders and other somatic disorders poses a significant challenge for the individual clinician working with veterans who report a history of mild traumatic brain injury (mTBI). In this article, common co-occurring symptoms and disorders will be described in relation to the population of veterans with mTBI, using a retrospective analysis of data from initial screening and secondary level evaluation for traumatic brain injury (TBI) in an urban Veteran's Affairs Medical Center.
Four hundred two veterans of the recent conflicts who received secondary level evaluation for TBI following positive TBI screening.
Significant differences were detected in symptom reporting between those who screened positive and those who screened negative on psychiatric screening. Those with positive posttraumatic stress disorder and depression screens endorsed more cognitive and affective symptoms; individuals screening positive for alcohol abuse did not report significantly more symptoms. Individuals without positive psychiatric screens reported fewer symptoms than those with positive screens. Consideration of these data in the context of a clinical case will be used to elucidate the challenge this presents to the clinical team.
The presence of co-occurring disorders should be considered in the etiology of a veteran's continued symptomatic complaints following TBI.
精神障碍与其他躯体障碍的同时存在，对处理有轻度创伤性脑损伤（mTBI）病史的退伍军人的临床医生来说是一个重大挑战。本文将通过对城市退伍军人事务医疗中心创伤性脑损伤（TBI）初次筛查和二级评估数据的回顾性分析，描述 mTBI 退伍军人群体中常见的共病症状和障碍。
接受二级 TBI 评估的 402 名最近冲突中的退伍军人，他们在 TBI 筛查呈阳性后进行了评估。
在精神筛查呈阳性和阴性的退伍军人之间，症状报告存在显著差异。那些 PTSD 和抑郁筛查呈阳性的人报告了更多的认知和情感症状；酒精滥用筛查呈阳性的人并没有报告更多的症状。没有精神筛查阳性的人报告的症状比筛查阳性的人少。将这些数据置于临床案例背景下进行考虑，有助于阐明这对临床团队提出的挑战。
在 TBI 后，退伍军人持续出现症状的病因中，应考虑共病障碍的存在。
