Veterans with TBI returning home with other combat-related challenges

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Virginia Commonwealth University researchers have found that among traumatic brain injury-diagnosed veterans treated by the Veterans Health Administration between 2009 and 2011, the majority had a clinician-diagnosed mental health disorder and approximately half had both post-traumatic stress disorder (PTSD) and pain.

Traumatic brain injury (TBI) has been termed the signature injury of the wars in Iraq and Afghanistan, but the more defining condition of these wars is polytrauma (two or more injuries to an organ system), according to the researchers.

They found that 6 percent of veterans treated in this time frame simultaneously suffered from TBI, PTSD and pain. The constellation of TBI, PTSD and pain – the afflictions most frequently seen in service members returning from Iraq and Afghanistan who exhibit polytrauma – is known as the “polytrauma triad.”

“This research represents the first multi-year, nationwide assessment of the incidence of brain injuries and related combat injuries in veterans from the Iraq and Afghanistan conflicts and is the first step for VCU's new nationwide concussion consortium in getting a clearer understanding of how to best manage the short and long-term consequences of these wars,” said principal investigator David X. Cifu, M.D., chairman and Herman J. Flax, M.D., Professor in the VCU School of Medicine’s Department of Physical Medicine and Rehabilitation.

Cifu is also the principal investigator on a $62 million federal grant awarded in 2013 to oversee a national research consortium of universities, hospitals and clinics that will study what happens to service members and veterans who suffer mild traumatic brain injuries or concussions.

Titled “Traumatic brain injury, posttraumatic stress disorder, and pain diagnoses in OIF/OEF/OND Veterans,” the study was published this month in the Journal of Rehabilitation Research & Development, a journal published by the United States Department of Veterans Affairs.

When data from the three years were pooled, 9.6 percent of veterans were diagnosed with TBI, 29.3 percent were diagnosed with PTSD and 40.2 percent were diagnosed with pain. The full polytrauma triad expression (TBI, PTSD and pain) was diagnosed in 6 percent.

The article can be found at http://www.rehab.research.va.gov/jour/2013/509/pdf/jrrd-2013-01-0006.pdf.