Kennedy Jan E, Lu Lisa H, Reid Matthew W, Leal Felix O, Cooper Douglas B
Defense and Veterans Brain Injury Center, Department of Neurology, Brooke Army Medical Center, 3551 Roger Brooke Drive, JBSA Ft Sam Houston, TX.
Defense and Veterans Brain Injury Center, Polytrauma Rehabilitation Center, South Texas Veterans Health Care System, Audie L. Murphy Memorial VA Hospital, 7400 Merton Minter, San Antonio, TX.
Mil Med. 2019 Mar 1;184(Suppl 1):148-154. doi: 10.1093/milmed/usy321.
Post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) are identified as signature injuries of the Wars in Iraq and Afghanistan. Statistics have confirmed a high incidence of PTSD among military personnel with mild TBI (mTBI) who served in these conflicts. Although receiving less attention, individuals with a history of mTBI are also at increased risk for depressive disorders. This study examines the incidence and correlates of depression in service members with a history of mTBI received an average of 4-1/2 years prior to evaluation.
Retrospective analysis of 184 service members with a history of mTBI extracted from a data repository maintained at a military medical center.
One-third of the sample (34.2%) was clinically diagnosed with a depressive disorder in the month preceding evaluation. Of those with depression, 81% (51 of 63) were also diagnosed with PTSD. Proportionately more women than men had depression. Depression was more common among those who were undergoing a Military Evaluation Board and those who served in more than three combat deployments.
Results confirm chronically elevated the rates of depressive disorders and PTSD comorbidity among service members with a history of mTBI. Depression screening and treatment within the Military Health System should remain a priority for service members reporting a remote history of mTBI. Individuals with chronic PTSD, women, service members undergoing MEB and those who served in greater than three combat deployments are at particular risk.
创伤后应激障碍（PTSD）和创伤性脑损伤（TBI）被认定为伊拉克战争和阿富汗战争中的典型伤病。统计数据证实，在这些冲突中服役的轻度创伤性脑损伤（mTBI）军人中，创伤后应激障碍的发病率很高。虽然较少受到关注，但有mTBI病史的个体患抑郁症的风险也会增加。本研究调查了在评估前平均4年半有mTBI病史的军人中抑郁症的发病率及其相关因素。
对从军事医疗中心维护的数据存储库中提取的184名有mTBI病史的军人进行回顾性分析。
在评估前一个月，三分之一的样本（34.2%）被临床诊断患有抑郁症。在患有抑郁症的人中，81%（63人中的51人）也被诊断患有创伤后应激障碍。患抑郁症的女性比例高于男性。抑郁症在接受军事评估委员会评估的人员以及参加过三次以上战斗部署的人员中更为常见。
结果证实，有mTBI病史的军人中抑郁症和创伤后应激障碍共病的发生率长期居高不下。对于报告有mTBI既往史的军人，军事卫生系统内的抑郁症筛查和治疗应仍然是优先事项。患有慢性创伤后应激障碍的个体、女性、接受军事评估委员会评估的军人以及参加过三次以上战斗部署的军人尤其危险。
