Herrold Amy A, Smith Bridget, Aaronson Alexandra L, Coleman John, Pape Theresa L-B
Research Service & Center for Innovation and Complex Chronic Healthcare, Edward Hines Jr., VA Hospital, 5000 S 5th Ave, MC 151 H, Hines, IL.
Department of Psychiatry and Behavioral Sciences, Northwestern University, Feinberg School of Medicine, 710 N Lakeshore Dr., Chicago, IL.
Mil Med. 2019 Mar 1;184(Suppl 1):138-147. doi: 10.1093/milmed/usy306.
The purpose of this study is to characterize and describe the relationships between symptoms and functional impairment following mild traumatic brain injury (mTBI) and behavioral health conditions (BHCs) in order to inform evidence-based theories on why symptoms and functional impairments persist in some individuals but not others. This is a retrospective, multi-site, cross-sectional study utilizing data collected from a total of 289 Operation Iraqi Freedom/Operation Enduring Freedom Veterans who were classified into diagnostic groups using the symptom attribution and classification algorithm and the VA clinical reminder and comprehensive traumatic brain injury evaluation. The Neurobehavioral Symptom Inventory was used to assess mTBI symptom number and severity. The World Health Organization Disability Assessment Schedule 2.0 was used to assess functional impairment. Symptom profiles differed between diagnostic groups irrespective of symptom attribution method used. Veterans with both mTBI and BHCs and those with BHCs alone had consistently greater number of symptoms and more severe symptoms relative to no symptom and symptoms resolved groups. Symptom number and severity were significantly associated with functional impairment. Both symptom number and functional impairment were significantly associated with the number of mTBI exposures. Together, these results informed evidence-based theories on understanding why symptoms and functional impairment persist among some OEF/OIF Veterans.
本研究的目的是描述和阐述轻度创伤性脑损伤（mTBI）及行为健康状况（BHCs）后症状与功能障碍之间的关系，以便为基于证据的理论提供依据，解释为何某些个体的症状和功能障碍持续存在而另一些个体则不然。这是一项回顾性、多中心横断面研究，利用从总共289名伊拉克自由行动/持久自由行动退伍军人收集的数据，这些退伍军人使用症状归因和分类算法以及退伍军人事务部临床提醒和综合创伤性脑损伤评估被分类到诊断组。使用神经行为症状量表评估mTBI症状的数量和严重程度。使用世界卫生组织残疾评估量表2.0评估功能障碍。无论使用何种症状归因方法，各诊断组的症状概况均有所不同。与无症状组和症状已缓解组相比，同时患有mTBI和BHCs的退伍军人以及仅患有BHCs的退伍军人的症状数量始终更多，症状也更严重。症状数量和严重程度与功能障碍显著相关。症状数量和功能障碍均与mTBI暴露次数显著相关。这些结果共同为基于证据的理论提供了依据，以理解为何某些持久自由行动/伊拉克自由行动退伍军人的症状和功能障碍会持续存在。
