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寻求与无家可归相关服务的退伍军人中的创伤性脑损伤、精神疾病诊断和自杀风险。

Traumatic brain injury, psychiatric diagnoses, and suicide risk among Veterans seeking services related to homelessness.

作者信息

Brenner Lisa A, Hostetter Trisha A, Barnes Sean M, Stearns-Yoder Kelly A, Soberay Kelly A, Forster Jeri E

机构信息

a Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC) , Denver Veterans Affairs Medical Center (VAMC) , Denver , CO , USA.

b Departments of Psychiatry, Neurology, and Physical Medicine and Rehabilitation , University of Colorado School of Medicine, Anschutz Medical Campus , Aurora , CO , USA.

出版信息

Brain Inj. 2017;31(13-14):1731-1735. doi: 10.1080/02699052.2017.1376758. Epub 2017 Oct 24.

Abstract

OBJECTIVES

To explore the differences in negative psychiatric outcomes (i.e. type and number of psychiatric diagnoses, suicide risk) among Veterans with and without a history of traumatic brain injury (TBI) seeking homeless services.

METHODS

Observational design with data collected at one time-point. Veterans seeking homeless services from two Veteran Affairs (VA) Medical Centres completed study measures (n = 309; 282 with a history of TBI and 27 without a history of TBI). Veterans participated in structured clinical interviews regarding psychiatric and TBI histories.

RESULTS

Those with a history of TBI met the criteria for significantly more psychiatric diagnoses (p = 0.0003), and were more likely to be at risk for suicide (p = 0.007) than those without a history of TBI.

CONCLUSIONS

Even among the high-risk cohort of homeless Veterans, those with a history of TBI were found to be at even greater risk for negative psychiatric outcomes. Further research is required to determine if and how the history of TBI contributes to the inability to maintain stable housing. Moreover, the findings highlight both the importance of assessing for history of TBI among this cohort, and educating providers regarding how to address the needs related to injury sequelae.

摘要

目的

探讨有创伤性脑损伤(TBI)病史和无创伤性脑损伤病史的寻求无家可归者服务的退伍军人在负面精神科结果(即精神科诊断的类型和数量、自杀风险)方面的差异。

方法

采用在一个时间点收集数据的观察性设计。从两个退伍军人事务(VA)医疗中心寻求无家可归者服务的退伍军人完成了研究测量(n = 309;282人有TBI病史,27人无TBI病史)。退伍军人参与了关于精神科和TBI病史的结构化临床访谈。

结果

有TBI病史的人符合精神科诊断标准的数量显著更多(p = 0.0003),并且比无TBI病史的人更有可能有自杀风险(p = 0.007)。

结论

即使在无家可归退伍军人这一高危人群中,有TBI病史的人被发现出现负面精神科结果的风险更高。需要进一步研究以确定TBI病史是否以及如何导致无法维持稳定住房。此外,研究结果凸显了在这一人群中评估TBI病史的重要性,以及对医疗服务提供者进行关于如何满足与损伤后遗症相关需求的教育的重要性。

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