Prevalence of mental health conditions after military blast exposure, their co-occurrence, and their relation to mild traumatic brain injury

Abstract

Primary objectives: To measure common psychiatric conditions after military deployment with blast exposure and test relationships to post-concussion syndrome (PCS) symptoms and mild traumatic brain injury (mTBI) history.

Research design: Cross-sectional.

Methods and procedures: Service members or Veterans (n = 107) within 2 years of blast exposure underwent structured interviews for mTBI, post-traumatic stress disorder (PTSD) and multiple mood and anxiety diagnoses.

Main outcomes and results: MTBI history and active PTSD were both common, additionally 61% had at least one post-deployment mood or anxiety disorder episode. Psychiatric diagnoses had a high degree of comorbidity. Most dramatically, depression was 43-times (95% CI = 11–165) more likely if an individual had PTSD. PCS symptoms were greater in those with post-deployment PTSD or mood diagnosis. However, neither mTBI nor blast exposure history had an effect on the odds of having PTSD, mood or anxiety condition.

Conclusions: These findings support that psychiatric conditions beyond PTSD are common after military combat deployment with blast exposure. They also highlight the non-specificity of post-concussion type symptoms. While some researchers have implicated mTBI history as a contributor to post-deployment mental health conditions, no clear association was found. This may partly be due to the more rigorous method of retrospective mTBI diagnosis determination.

• Mood disorders
• anxiety disorders
• post-traumatic stress disorder
• concussion
• traumatic brain injury
• explosive blast

Acknowledgments

This material is in part based upon work supported in part by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development and Rehabilitation Research and Development Career Development Award-2 (1IK2RX000703-01; S.M.). The views expressed are those of the authors and do not necessarily represent or reflect the policy or position of the Department of the Army, Department of Defense, the US Government, the Department of Veterans Affairs or any of the institutions with which the authors are affiliated.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

This work was funded primarily by the Congressionally Directed Medical Research Projects (CDMRP) Award #W91ZSQ8118N620 with some support from the Defense and Veterans Brain Injury Center (DVBIC).