Study: PTSD signals longer-term health problems
January 3rd, 2011
04:35 PM ET

Study: PTSD signals longer-term health problems

U. S. soldiers who experienced post-traumatic stress disorder  during combat in Iraq were more likely to experience longer-term health problems including depression, headaches, tinnitis, irritability and memory problems compared with soldiers who experienced only concussions without PTSD. The study concludes that screening for PTSD among troops is critical for identifying and treating long-term health problems. The findings are published in the JAMA Archives of General Psychiatry.

Since Operation Desert Storm launched 20  years ago, millions of U.S. troops have been deployed to Iraq and Afghanistan.  Combat exposure often places troops at risk of suffering psychological trauma and injury when they are exposed to the blasts from improvised explosive devices, according to background information in the study, and traumatic brain injury has often been called the “signature injury” of the conflicts. The study says that most TBIs are mild – better known as concussions. The symptoms of concussion, or MTBI,  include loss of consciousness, loss of memory, dizziness, and headache.

Recognizing the increased risk of MTBI and PTSD, the Department of Defense and the VA have instituted post-deployment screening to identify service members who may require further treatment or evaluation. The researchers explain that while other studies have shown that PTSD is linked to long-term health problems and disability, less is known about the long-term effects of concussion on health problems.

University of Minnesota Medical School and Minneapolis Veterans Affairs health care system researchers surveyed 2,677 soldiers from a U.S. National Guard Brigade Combat Team stationed in Iraq. Participants completed their first questionnaire in 2007, one month before their 16-month deployment ended. They answered questions about whether they had experienced a concussion,  and whether they were experiencing symptoms of PTSD and depression. 1,935 of those who took the first survey agreed to participate in further research. One year after they completed their first survey, the soldiers were mailed a second survey and 953 soldiers responded.

The first survey revealed that 9.2% of soldiers experienced symptoms of concussions and 30.2 percent of those soldiers had probable PTSD at the time of the survey. When they took the second survey, 22 percent of soldiers, twice as many, reported they had experienced concussions and of those, 30.4 percent got a diagnosis of probable PTSD. Reporting PTSD at the time of the first survey was strongly associated with having long-term health problems.

After adjusting for PTSD, the study found that those who experienced concussions without PTSD showed no lingering health effects. However, those with PTSD and MTBI experienced post-concussive symptoms and health problems including depression, irritability, memory problems and headaches.

“The present study is the first, to our knowledge, to show that a history of concussion/MTBI alone does not contribute to long-term impairments in the health and well-being of Operation Iraqi Freedom on veterans," the researchers wrote. "These data showing that PTSD often underlies persisting post-concussion syndrome suggest that early identification and evidence-based treatment of PTSD may be critical to management of post-deployment post-concussion symptoms,” the researchers conclude.

“Although combat-related PTSD was strongly associated with post-concussive symptoms and psychosocial outcomes one year after soldiers return from Iraq, there was little evidence of a long-term negative impact of concussion/mild traumatic brain injury history on these outcomes after accounting for PTSD,” the authors write in their conclusion. “These findings and the two-fold increase in reports of deployment-related concussion/MTBI history have important implications for screening and treatment,” according to the study.

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