Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.
General Dynamics Information Technology, Silver Spring, MD, USA.
NeuroRehabilitation. 2024;55(3):295-302. doi: 10.3233/NRE-230274.
While there is extensive empirical support and clinical guidance for the treatment of mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) individually, less is known about treating the comorbid presentation of both conditions.
The purpose of this review article is to provide information on the mental health treatment needs of service members (SMs) engaged in traumatic brain injury (TBI) rehabilitation. It also aims to offer a framework for an integrated treatment approach to address the cognitive and psychological health needs of warfighters.
We review the prevalence and outcomes associated with comorbid TBI and PTSD and present relevant access to care considerations. Additionally, we identify an integrated approach to TBI treatment which takes psychological trauma into consideration. We introduce a trauma-informed care (TIC) model with specified diagnostic and treatment considerations for the service member and veteran (SM/V) communities. TIC is a strengths-based framework that raises the system-wide awareness of treatment facilities to the impact of psychological trauma on behavioral health.
A comprehensive diagnostic approach is recommended with considerations for symptom etiology. Clinical considerations derived from available guidelines are identified to meet critical treatment needs for SM/Vs presenting for TBI treatment with a remote history of mTBI and psychological trauma or known PTSD. Clinical practice guidelines are used to inform an integrated TBI treatment model and maximize rehabilitation efforts for warfighters.
Given the prevalence of comorbid TBI and PTSD among SM/Vs and its impact on outcomes, this review presents the integration of appropriate diagnostics and treatment practices, including the incorporation of clinical practice guidelines (CPGs) into TBI rehabilitation.
虽然针对轻度创伤性脑损伤 (mTBI) 和创伤后应激障碍 (PTSD) 的治疗已经有了广泛的经验支持和临床指导，但对于同时治疗这两种疾病的共病表现，了解得较少。
本文旨在为参与脑损伤康复的军人提供有关心理健康治疗需求的信息。它还旨在提供一种综合治疗方法的框架，以满足战斗人员的认知和心理健康需求。
我们回顾了共病 TBI 和 PTSD 的患病率和结果，并提出了相关的治疗途径考虑因素。此外，我们确定了一种综合的 TBI 治疗方法，该方法考虑到了心理创伤。我们引入了一种创伤知情护理 (TIC) 模型，为军人和退伍军人社区规定了特定的诊断和治疗注意事项。TIC 是一种基于优势的框架，它提高了治疗设施对心理创伤对行为健康影响的系统认识。
建议采用全面的诊断方法，并考虑症状的病因。从现有指南中确定了临床考虑因素，以满足因远程 mTBI 和心理创伤或已知 PTSD 而接受 TBI 治疗的军人的关键治疗需求。临床实践指南用于为综合 TBI 治疗模型提供信息，并最大限度地提高战斗人员的康复效果。
鉴于军人和退伍军人中 TBI 和 PTSD 的共病率及其对结果的影响，本文提出了适当的诊断和治疗实践的整合，包括将临床实践指南 (CPG) 纳入 TBI 康复。
