» Back to list of all Management eBriefs
|Issue 145||August 2018|
The report is a product of the VA/HSR&D Evidence Synthesis Program.
A Systematic Review: Relationship of Deployment-related Mild TBI to Psychiatric Conditions
Approximately 10% of active duty service members deployed to Iraq and/or Afghanistan between 2003 and 2014 received a new diagnosis of traumatic brain injury (TBI) within three years of their return. From the start of required screening for this injury in 2007 through September 2016, more than one million Veterans were screened for TBI in the VA healthcare system: 83,318 Veterans were diagnosed with TBI, mostly mild TBI (mTBI).
Veterans who served in Iraq and/or Afghanistan also are at increased risk for psychiatric conditions including PTSD, depressive disorders, substance use disorders, suicidal ideation or attempts, and anxiety disorders. However, it is unknown whether these psychiatric conditions are more common among these service members and Veterans with a deployment-related TBI than among those without TBI — and whether mental illness treatment effectiveness varies based on TBI status. Therefore, this systematic review focused on the prevalence of psychiatric conditions and the effectiveness of mental health interventions in service members and Veterans with a history of deployment-related mTBI.
Investigators with VA's Evidence-based Synthesis Program (ESP) Center in Minneapolis, MN searched MEDLINE, PsycINFO, the Published International Literature on Traumatic Stress (PILOTS) database, VA HSR&D publications, and the Defense and Veterans Brain Injury Center (DVBIC) for English language publications indexed from 2000 to October 2017. They also reviewed suggested articles from Operational Partners and a five-member Technical Expert Panel (TEP) — both of which provided consultation and feedback. After screening 1,215 articles, 41 studies were included in this review.
Summary of Findings
Specific findings from the national samples include
Behavioral treatments for PTSD achieved minimal clinically important differences for changes in PTSD and depressive symptoms in Veterans with a history of TBI, with no indication of harm. Results from studies that included groups with and without a history of TBI suggest that TBI status does not affect treatment outcomes. Lacking usual care or wait-list control groups in the predominantly pre- to post-treatment studies, the strength of the evidence for the effectiveness of interventions for psychiatric conditions in service members and Veterans with a history of mTBI is insufficient. Some specific findings include:
**A cyberseminar session titled "The Relationship of Mild TBI to PTSD, Depression, Substance Abuse, Suicidal Ideation, and Anxiety Disorders: A Systematic Review" will be held on Thursday, November 8, 2018 from 12:00pm to 1:00pm (ET). Register for this session.**
View the full report — **VA Intranet only**:
Please feel free to forward this information to others!
ESP is currently soliciting review topics from the broader VA community. Nominations will be accepted electronically using the online Topic Submission Form. If your topic is selected for a synthesis, you will be contacted by an ESP Center to refine the questions and determine a timeline for the report.
This Management e-Brief is provided to inform you about recent HSR&D findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR&D Resource Center charged with disseminating important HSR&D findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.
This report is a product of VA/HSR&D's Quality Enhancement Research Initiative's (QUERI) Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers –; and to disseminate these reports throughout VA.
See all reports online.