Postconcussion Syndrome in Veterans

Jacey Kant

June 29, 2022

Interaction Between Psychiatric Symptoms and History of Mild TBI When Evaluating Postconcussion Syndrome in Veterans

A concussion is often referred to as a mild traumatic brain injury (mTBI). mTBI occur when someone has a blow to the head, such as while playing a contact sport, in a car accident, or as the result of an assault. Those who sustain an mTBI may have symptoms including headaches, sensitivity to light, and memory loss, to name a few. Negative effects to mental health could also be a result of mTBI. While these symptoms are normally short-lasting, when symptoms last longer than what is expected, it is often referred to as postconcussion syndrome (PCS).

The goal of this study was to learn if psychiatric symptoms, such as depression or anxiety, have a greater effect on prolonged post concussive symptoms than mTBI. This study specifically examined veterans recently returned from deployment. A test commonly used to assess post concussive symptoms, called the Neurobehavioral Symptom Inventory (NSI), was used along with many other questionnaires to evaluate symptoms of those who participated in this study. Additional questionnaires assessed depression, anxiety, post-traumatic stress disorder (PTSD), mental health stigma, alcohol abuse, combat exposure, attention deficit hyperactivity disorder (ADHD), social support, and childhood abuse. Researchers then used the information they collected to run different tests that determined which factors were most likely to be the cause of PCS.

The results of the study showed that, within this group of people, PTSD and depression symptoms had a large effect on the severity of postconcussive symptoms that participants were experiencing. Although those with a history of mTBI reported more postconcussive symptoms, results showed when considering psychological distress symptoms, mTBI was not found to be the main cause of more severe PCS. Additionally, history of psychological abuse and female gender were associated with increased PCS symptoms though this is likely explained through greater depression. On the other hand, combat exposure was related to a lower number of PCS symptoms. Based on these findings, when people report PCS, it may be more influenced by psychological issues than mTBI. While the NSI is commonly used in the VA system and was used in this study, it is not the only test used to assess PCS. Regardless of which measure is being used, healthcare clinicians should keep in mind that it may not accurately capture mTBI symptoms, as various psychological symptoms and factors could affect the results.

Larsen, S. E., Larson, E. R., Hunt, J. C., Lorber, W. G., & deRoon-Cassini, T. A.. (2019). Interaction Between Psychiatric Symptoms and History of Mild TBI When Evaluating Postconcussion Syndrome in Veterans. Military Medicine.