Psychiatric diagnoses among Iraq and Afghanistan war veterans screened for deployment-related traumatic brain injury

Authors

  • Kathleen F. Carlson,

    Corresponding author
    1. Center for Chronic Disease Outcomes Research, VA Medical Center, and Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
    • Center for Chronic Disease Outcomes Research, VA Medical Center (152/2E), One Veterans Drive, Minneapolis, MN 55417
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  • David Nelson,

    1. Center for Chronic Disease Outcomes Research, VA Medical Center, and Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
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  • Robert J. Orazem,

    1. Center for Chronic Disease Outcomes Research, VA Medical Center, Minneapolis, MN
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  • Sean Nugent,

    1. Center for Chronic Disease Outcomes Research, VA Medical Center, Minneapolis, MN
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  • David X. Cifu,

    1. Physical Medicine and Rehabilitation Services, Veterans Health Administration, Physical Medicine and Rehabilitation Service, Hunter Holmes McGuire VA Medical Center, and Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA
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  • Nina A. Sayer

    1. Center for Chronic Disease Outcomes Research, VA Medical Center, and Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
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  • This work was supported by VA Health Services Research and Development, Polytrauma and Blast-Related Injuries Quality Enhancement Research Initiative, Locally Initiated Project Grant PLY 05-403-5. The authors acknowledge the veterans of Operations Enduring Freedom and Iraqi Freedom, and their families, for their service to our country. The opinions expressed in this paper do not necessarily represent those of the Department of Veterans Affairs.

Abstract

The authors examined psychiatric diagnoses in administrative records for 13,201 United States military veterans who were screened for traumatic brain injury (TBI) in Department of Veterans Affairs facilities. Over 80% of the veterans with positive TBI screens had psychiatric diagnoses. Compared to veterans with negative TBI screens, those with positive screens, but without confirmed TBI status, were three times more likely to have a posttraumatic stress disorder (PTSD) diagnosis and were two times more likely to have depression and substance-related diagnoses. Among veterans with positive TBI screens, those with clinically confirmed TBI status were more likely than those without confirmed TBI status to have diagnoses for PTSD, anxiety, and adjustment disorders. These findings have implications for health care delivery and provider education.

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