Psychiatry. 2024 Winter;87(4):314-328. doi: 10.1080/00332747.2024.2392226. Epub 2024 Aug 26.
This study provides nationally representative data on the prevalence, risk factors, and associated mental health and functional outcomes of mild traumatic brain injury (mTBI) in U.S. military veterans.
Data ( = 4,069) were analyzed from the National Health and Resilience in Veterans Study (NHRVS). Analyses estimated mTBI prevalence, exposure to different mTBI injuries, and past-week mTBI symptoms (i.e. persistent post-concussive symptoms [PCS]). Comparisons were made between veterans with and without mTBI+PCS on sociodemographic, military, trauma, and psychiatric characteristics. Associations between mTBI+PCS and measures of cognitive, mental, and psychosocial functioning were examined.
Overall, 43.7% endorsed a possible mTBI event on the Veterans Affairs' Mild TBI Injury Screening and Evaluation tool, and 10.0% screened positive for mTBI. After combining a self-reported healthcare professional diagnosis of concussion/mTBI/TBI (5.8%) with a positive mTBI screen, the prevalence of mTBI+PCS was 3.0%. Veterans with specific trauma characteristics (e.g. adverse childhood events), military service (e.g. combat), and lifetime psychiatric conditions were more likely to have mTBI+PCS. mTBI+PCS was associated with increased odds of current posttraumatic stress disorder, major depressive disorder, generalized anxiety disorder, and drug use disorder. These veterans also scored significantly lower on cognitive, mental, and psychosocial functioning.
Overall, 3.0% of veterans had mTBI+PCS, suggesting that while mTBI may be prevalent in this population, the majority will likely recover without developing chronic symptoms. Those with mTBI+PCS are at significant risk for comorbid psychiatric diagnoses and poorer psychosocial functioning relative to those without mTBI+PCS, and early targeted identification may assist in prevention of disability and recovery.
本研究提供了美国退伍军人中轻度创伤性脑损伤（mTBI）的患病率、风险因素以及相关心理健康和功能结果的全国代表性数据。
对来自退伍军人健康和韧性研究（NHRVS）的数据（ = 4069）进行了分析。分析估计了 mTBI 的患病率、不同 mTBI 损伤的暴露情况以及过去一周的 mTBI 症状（即持续性脑震荡后症状 [PCS]）。比较了有和没有 mTBI+PCS 的退伍军人在社会人口统计学、军事、创伤和精神特征方面的差异。还研究了 mTBI+PCS 与认知、精神和心理社会功能测量之间的关联。
总体而言，43.7%的退伍军人在退伍军人事务部的轻度创伤性脑损伤筛查和评估工具上报告了可能的 mTBI 事件，10.0%的退伍军人 mTBI 筛查阳性。在将自我报告的医疗专业人员诊断的脑震荡/mTBI/TBI（5.8%）与阳性 mTBI 筛查相结合后，mTBI+PCS 的患病率为 3.0%。具有特定创伤特征（例如，不良童年经历）、军事服务（例如，战斗）和终身精神疾病的退伍军人更有可能患有 mTBI+PCS。mTBI+PCS 与当前创伤后应激障碍、重度抑郁症、广泛性焦虑症和药物使用障碍的发生几率增加有关。这些退伍军人在认知、精神和心理社会功能方面的得分也明显较低。
总体而言，3.0%的退伍军人患有 mTBI+PCS，这表明尽管 mTBI 在该人群中可能较为普遍，但大多数人可能会在没有出现慢性症状的情况下康复。与没有 mTBI+PCS 的退伍军人相比，患有 mTBI+PCS 的退伍军人有发生共病性精神诊断和较差的心理社会功能的显著风险，早期有针对性的识别可能有助于预防残疾和康复。
