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Torner J, Mengeling M, Booth BM, Sadler AG. Women Veterans: Head Injury Prevalence and Associated Medical Conditions Among Women. Paper presented at: VA HSR&D Field-Based Mental Health and Substance Use Disorders Meeting; 2010 Apr 29; Little Rock, AR.
Objectives To investigate the current health and potential consequences of head injured female veterans. Head injury and associated mental changes in veterans has been of concern because of lasting psychological and cognitive deficits. Although head injury in military populations, both in peace time and war time, has been documented and current research has documented a 4.9% incidence of loss of consciousness in 2,525 soldiers, little information is available on the frequency and consequences for female veterans. Few studies have included examined the rate in women because of the low numbers in military action. Our study investigates the health of women who served in recent military operations. Methods 1004 women participated in a retrospective cohort study of current health, health risk behaviors and health care utilization of women with and without lifetime sexual assault exposure. Consenting women veterans enrolled in the Iowa City VAMC and clinics within the preceding 5 years ( < 51 years of age) completed a computer-assisted telephone interview assessing socio-demographic variables, rape exposures, heath history, gynecologic diagnoses, procedures and care utilization, health status, health risk behaviors, post-rape care, post-traumatic stress, and access to care. Results The majority of participants were white, employed, married, and well educated. 29% served in a combat area or war zone. Almost two thirds (62%) of the sample acknowledged one or more sexual assaults (SA, attempted and/or completed) during their lifetime and 28% acknowledged SA during military. Head injury prevalence was reported in 34.1% (342/1004) of women respondents. Of those with a head injury 56.1% (192) had a loss of consciousness with the injury. Lifetime substance abuse was significantly higher in those with head injuries (51.8% v 44.2%, p = .0226). Psychological disorders were also more prevalent in the head injured veterans with increases in depression (60.4% v 48.6%, p = .0004), attempted suicide (29.6% v 17.1%, p < .0001), anxiety (32.9% v 22.6%, p = .0004), panic (14.6% v 9.1%, p = .0089), PTSD (31.5% v 19.4%, p < .0001) and OCD (8.8% v 2.7%, p < .0001). Persons with head injuries were more likely to have headaches (53.7% v 38.5%, p < .0001) and fibromyalgia (15.3% v 7%, p < .0001). These women also had more chronic medical conditions. Current employment was lower in the head injured subjects 54.1% versus 67.4% in women not head injured (p < .0001). The frequency of head injury is high with associated psychological conditions. In combination with the head injury the mental health status of these women was lower. Implications The frequency of head injury is high in this population. Head injury is associated with greater rates of several psychological conditions, including PTSD and depression. Pain disorders such as fibromyalgia are also higher in this population. Lower employment demonstrates a combined influence of several mental health factors including head injury. Impacts Identification of head injuries that have psychological or cognitive deficits is important in determining the need for evaluation and rehabilitative services. This recognition and intervention is important in the employment and social reintegration of these veterans.