The Assessment and Treatment of Individuals with History of Traumatic Brain Injury and Post-Traumatic Stress Disorder
A Systematic Review of the Evidence
Evidence-based Synthesis Program
Principal Investigator: Kathleen Carlson, PhD; Co-Investigators: Shannon Kehle, PhD and Laura Meis, PhD. Research Associates: Nancy Greer, PhD, Rod MacDonald, MS, and Indulis Rutks, BA. Director: Timothy J Wilt, MD, MPH.Read
United States (U.S.) Veterans Affairs (VA) and Department of Defense (DoD) healthcare facilities are increasingly serving a large population of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans who have sustained traumatic brain injury (TBI), suffer from post-traumatic stress disorder (PTSD), or have both a history of TBI and current PTSD (TBI/PTSD). Mild TBI (mTBI) is considered the most common form of TBI. Uncertainty exists regarding the long-term health outcomes of mTBI as well as the validity of criteria used to assess for a history of this injury. Symptoms that may be attributable to mTBI are similar to symptoms of PTSD. It is unknown whether findings from civilian populations with both a history of mTBI and PTSD (mTBI/PTSD) are applicable to individuals with combat-related mTBI/PTSD. Current evidence-based practices to screen, diagnose, prospectively evaluate, and treat mTBI symptoms or PTSD may be less accurate or effective if and when these conditions co-occur. Thus, there is a need to develop an evidence base to identify best practices to define, diagnose, evaluate, and manage patients with mTBI/PTSD, particularly in U.S. veterans of OEF/OIF.
Prepared for: Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service, Washington, DC 20420. Prepared by: Minneapolis Veterans Affairs Medical Center, Minnesota Evidence Synthesis Program, Center for Chronic Disease Outcomes Research, Minneapolis, MN.
This report is based on research conducted by the Minneapolis Veterans Affairs Medical Center, Minnesota Evidence Synthesis Program, and the Center for Chronic Disease Outcomes Reasearch under contract to the Department of Veterans Affairs. The findings and conclusions in this document are those of the author(s) who are responsible for its contents; the findings and conclusions do not necessarily represent the views of the Department of Veterans Affairs. Therefore, no statement in this article should be construed as an official position of the Department of Veterans Affairs.
This report is intended as a reference and not as a substitute for clinical judgment.
This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. The Department of Veterans Affairs endorsement of such derivative products may not be stated or implied.