Psychiatr News March 21, 2008
Volume 43, Number 6, page 23
© 2008 American Psychiatric Association
Careful Diagnosis at Time of Injury Is Key to Recovery
The Department of Defense is evaluating the study by Col. Charles Hoge,
M.C., and colleagues about whether changes are needed in screening or
treatment programs for mild traumatic brain injury and PTSD after soldiers
return from combat deployments (see Blast Injury Sequelae Linked to PTSD).
Cynthia Vaughan, a spokesperson for the Army Surgeon General's Office,
responded to a request for comments with the following statement, which has
been slightly abbreviated for space reasons:
"Full recovery from concussion (which is also known as mild traumatic
brain injury—mTBI) is expected, usually in a matter of days with the
initial interventions being rest, education, and protection from a subsequent
injury during the period of cerebral vulnerability. It is important that the
expectation of full and quick recovery be communicated to the patient....
"However, it is very important for us to record all injuries at the
time of injury even if full recovery is expected. When soldiers return home,
family members may think that symptoms such as irritability, fatigue, sleep
problems, or forgetfulness are caused by a brain injury, when they may
actually be related to posttraumatic stress or depression. These symptoms may
also be normal reactions to combat or reactions that one would expect after
any injury, since none of the symptoms are exclusive to the aftereffects of a
brain injury. It is very important that soldiers receive the right treatment
at the point of injury and throughout the continuum of care. It is incumbent
on providers to identify if concussion, posttraumatic stress, or depression is
affecting their patients as there are effective treatments for these
disorders.
"Col. Hoge's study indicated that PTSD is more common in soldiers who
had concussions than in soldiers with other types of injuries. As with
civilian concussion, further research is needed to determine the effects of
multiple concussions and any potential long-term effects.
"The Army continues to screen soldiers for concussions and for
posttraumatic stress, as well as to train health care providers, military
leaders, and soldiers to recognize symptoms of postcombat stress and
concussion—and how and when to seek health care. The important thing is
to address all the health concerns regardless of the cause, as well as any
underlying factors that may be making symptoms worse, such as depression or
posttraumatic stress."
Related Article:
-
Blast Injury Sequelae Linked to PTSD
- Aaron Levin
Psychiatr News 2008 43: 23-30.
[Full Text]
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