Association of Traumatic Brain Injury Severity and Self-Reported Neuropsychiatric Symptoms in Wounded Military Service Members

The impact of traumatic brain injury (TBI) severity and loss of consciousness (LOC) on the development of neuropsychiatric symptoms was studied in injured service members (SMs; n?=?1278) evacuated from combat settings between 2003 and 2012. TBI diagnoses of mild TBI (mTBI) or moderate-to-severe TBI...

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Main Authors: Sharon Y. Kim, Alyssa A. Soumoff, Sorana Raiciulescu, Patricia A. Kemezis, Elizabeth A. Spinks, David L. Brody, Vincent F. Capaldi, Robert J. Ursano, David M. Benedek, Kwang H. Choi
Format: Article
Language:English
Published: Mary Ann Liebert 2023-01-01
Series:Neurotrauma Reports
Subjects:
Online Access:https://www.liebertpub.com/doi/full/10.1089/NEUR.2022.0063
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author Sharon Y. Kim
Alyssa A. Soumoff
Sorana Raiciulescu
Patricia A. Kemezis
Elizabeth A. Spinks
David L. Brody
Vincent F. Capaldi
Robert J. Ursano
David M. Benedek
Kwang H. Choi
author_facet Sharon Y. Kim
Alyssa A. Soumoff
Sorana Raiciulescu
Patricia A. Kemezis
Elizabeth A. Spinks
David L. Brody
Vincent F. Capaldi
Robert J. Ursano
David M. Benedek
Kwang H. Choi
author_sort Sharon Y. Kim
collection DOAJ
description The impact of traumatic brain injury (TBI) severity and loss of consciousness (LOC) on the development of neuropsychiatric symptoms was studied in injured service members (SMs; n?=?1278) evacuated from combat settings between 2003 and 2012. TBI diagnoses of mild TBI (mTBI) or moderate-to-severe TBI (MS-TBI) along with LOC status were identified using International Classification of Diseases, Ninth Revision (ICD-9) codes and the Defense and Veterans Brain Injury Center Standard Surveillance Case Definition for TBI. Self-reported psychiatric symptoms were evaluated for post-traumatic stress disorder (PTSD) with the PTSD Checklist, Civilian Version for PTSD, the Patient Health Questionnaire-9 for major depressive disorder (MDD), and the Patient Health Questionnaire-15 for somatic symptom disorder (SSD) in two time periods post-injury: Assessment Period 1 (AP1, 0.0?2.5 months) and Assessment Period 2 (AP2, 3?12 months). mTBI, but not MS-TBI, was associated with increased neuropsychiatric symptoms: PTSD in AP1 and AP2; MDD in AP1; and SSD in AP2. A subgroup analysis of mTBI with and without LOC revealed that mTBI with LOC, but not mTBI without LOC, was associated with increased symptoms as compared to non-TBI: PTSD in AP1 and AP2; MDD in AP1; and SSD in AP1 and AP2. Moreover, mTBI with LOC was associated with increased MDD symptoms in AP2, and SSD symptoms in AP1 and AP2, compared to mTBI without LOC. These findings reinforce the need for the accurate characterization of TBI severity and a multi-disciplinary approach to address the devastating impacts of TBI in injured SMs.
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spelling doaj.art-60d934b0c88340998b4cef993073fafa2024-01-26T04:43:56ZengMary Ann LiebertNeurotrauma Reports2689-288X2023-01-0141142410.1089/NEUR.2022.0063Association of Traumatic Brain Injury Severity and Self-Reported Neuropsychiatric Symptoms in Wounded Military Service MembersSharon Y. KimAlyssa A. SoumoffSorana RaiciulescuPatricia A. KemezisElizabeth A. SpinksDavid L. BrodyVincent F. CapaldiRobert J. UrsanoDavid M. BenedekKwang H. ChoiThe impact of traumatic brain injury (TBI) severity and loss of consciousness (LOC) on the development of neuropsychiatric symptoms was studied in injured service members (SMs; n?=?1278) evacuated from combat settings between 2003 and 2012. TBI diagnoses of mild TBI (mTBI) or moderate-to-severe TBI (MS-TBI) along with LOC status were identified using International Classification of Diseases, Ninth Revision (ICD-9) codes and the Defense and Veterans Brain Injury Center Standard Surveillance Case Definition for TBI. Self-reported psychiatric symptoms were evaluated for post-traumatic stress disorder (PTSD) with the PTSD Checklist, Civilian Version for PTSD, the Patient Health Questionnaire-9 for major depressive disorder (MDD), and the Patient Health Questionnaire-15 for somatic symptom disorder (SSD) in two time periods post-injury: Assessment Period 1 (AP1, 0.0?2.5 months) and Assessment Period 2 (AP2, 3?12 months). mTBI, but not MS-TBI, was associated with increased neuropsychiatric symptoms: PTSD in AP1 and AP2; MDD in AP1; and SSD in AP2. A subgroup analysis of mTBI with and without LOC revealed that mTBI with LOC, but not mTBI without LOC, was associated with increased symptoms as compared to non-TBI: PTSD in AP1 and AP2; MDD in AP1; and SSD in AP1 and AP2. Moreover, mTBI with LOC was associated with increased MDD symptoms in AP2, and SSD symptoms in AP1 and AP2, compared to mTBI without LOC. These findings reinforce the need for the accurate characterization of TBI severity and a multi-disciplinary approach to address the devastating impacts of TBI in injured SMs.https://www.liebertpub.com/doi/full/10.1089/NEUR.2022.0063combat exposure stressloss of consciousness (LOC)major depressive disorder (MDD)post-traumatic stress disorder (PTSD)somatic symptom disorder (SSD)traumatic brain injury (TBI)
spellingShingle Sharon Y. Kim
Alyssa A. Soumoff
Sorana Raiciulescu
Patricia A. Kemezis
Elizabeth A. Spinks
David L. Brody
Vincent F. Capaldi
Robert J. Ursano
David M. Benedek
Kwang H. Choi
Association of Traumatic Brain Injury Severity and Self-Reported Neuropsychiatric Symptoms in Wounded Military Service Members
Neurotrauma Reports
combat exposure stress
loss of consciousness (LOC)
major depressive disorder (MDD)
post-traumatic stress disorder (PTSD)
somatic symptom disorder (SSD)
traumatic brain injury (TBI)
title Association of Traumatic Brain Injury Severity and Self-Reported Neuropsychiatric Symptoms in Wounded Military Service Members
title_full Association of Traumatic Brain Injury Severity and Self-Reported Neuropsychiatric Symptoms in Wounded Military Service Members
title_fullStr Association of Traumatic Brain Injury Severity and Self-Reported Neuropsychiatric Symptoms in Wounded Military Service Members
title_full_unstemmed Association of Traumatic Brain Injury Severity and Self-Reported Neuropsychiatric Symptoms in Wounded Military Service Members
title_short Association of Traumatic Brain Injury Severity and Self-Reported Neuropsychiatric Symptoms in Wounded Military Service Members
title_sort association of traumatic brain injury severity and self reported neuropsychiatric symptoms in wounded military service members
topic combat exposure stress
loss of consciousness (LOC)
major depressive disorder (MDD)
post-traumatic stress disorder (PTSD)
somatic symptom disorder (SSD)
traumatic brain injury (TBI)
url https://www.liebertpub.com/doi/full/10.1089/NEUR.2022.0063
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