Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, Minnesota (Drs Greer, Sayer, Spoont, Taylor, Ackland, and Wilt, Mr MacDonald, and Mss McKenzie and Rosebush); Minneapolis VA Evidence-Based Synthesis Program Center, Minneapolis VA Health Care System, Minneapolis, Minnesota (Drs Greer and Wilt, Mr MacDonald, and Mss McKenzie and Rosebush); Departments of Medicine (Drs Sayer, Spoont, Taylor, Ackland, and Wilt) and Psychiatry (Dr Sayer) and Division of Epidemiology and Community Health (Dr Taylor), University of Minnesota, Minneapolis; and US Department of Veterans Affairs National Center for PTSD, Honolulu, Hawaii (Dr Spoont).
J Head Trauma Rehabil. 2020 Jan/Feb;35(1):1-13. doi: 10.1097/HTR.0000000000000478.
Assess prevalence and severity of posttraumatic stress disorder, suicidal behavior, and depressive, substance use, and anxiety disorders in US service members or Veterans with and without a deployment-related mild traumatic brain injury (TBI) (mTBI).
Systematic review using multiple databases (January 2000 to October 2017). We included national or geographically diverse samples.
Prevalence and severity of psychiatric conditions based on diagnostic codes, clinician assessments, and self-report measures with results stratified by sample type.
We identified 11 studies on the basis of national samples and 22 studies on the basis of geographically diverse samples. Traumatic brain injury severity was not always ascertained or reported. In national studies, posttraumatic stress disorder, depressive disorder, substance use disorder, and anxiety disorder prevalence were higher in those with TBI than in those without. One national sample reported prevalence of suicide attempts. Across psychiatric conditions, strength of evidence ranged from insufficient to moderate. In geographically diverse samples, the pattern of findings was similar. National studies provided insufficient evidence on psychiatric condition severity; geographically diverse studies found greater severity of posttraumatic stress disorder symptoms with mixed results for symptoms of depressive or substance use disorders.
Service members and Veterans with TBI history have higher prevalence and possibly severity of selected psychiatric conditions.
评估有和没有与部署相关的轻度创伤性脑损伤（mTBI）的美国现役军人或退伍军人中创伤后应激障碍、自杀行为以及抑郁、物质使用和焦虑障碍的发生率和严重程度。
使用多个数据库进行的系统评价（2000 年 1 月至 2017 年 10 月）。我们纳入了全国性或地理上多样化的样本。
根据诊断代码、临床医生评估和自我报告的测量结果，对有和没有创伤性脑损伤的精神疾病的发生率和严重程度进行分层。
根据全国性样本，我们确定了 11 项研究；根据地理上多样化的样本，我们确定了 22 项研究。创伤性脑损伤的严重程度并非总是确定或报告。在全国性研究中，与没有创伤性脑损伤的人相比，有创伤性脑损伤的人出现创伤后应激障碍、抑郁障碍、物质使用障碍和焦虑障碍的发生率更高。一个全国性样本报告了自杀企图的发生率。在所有精神疾病中，证据强度从不足到中等不等。在地理上多样化的样本中，研究结果的模式相似。全国性研究提供的关于精神疾病严重程度的证据不足；地理上多样化的研究发现，创伤后应激障碍症状的严重程度更高，而抑郁或物质使用障碍症状的严重程度则存在混合结果。
有创伤性脑损伤史的现役军人和退伍军人患有某些精神疾病的发生率和严重程度可能更高。
