Salisbury VA Health Care System, Salisbury, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Wake Forest School of Medicine, Winston-Salem, NC, USA.
OBJECTIVE: Characterize behavioral and health outcomes in veterans with TBI acquired in non-deployment and deployment settings.
DESIGN: Cross-sectional assessment evaluating TBI acquired during and outside of deployment, mental and behavioral health symptoms, and diagnoses. SETTING: Veterans Affairs Medical Centers. PARTICIPANTS: Iraq and Afghanistan Veterans who deployed to a warzone (N = 1399). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Comprehensive lifetime TBI interview; Structured Clinical Interview for DSM-IV Disorders; Combat Exposure Scale; behavioral and health measures.
RESULTS: There was a main effect of deployment TBI on depressive symptoms, posttraumatic stress symptoms, poor sleep quality, substance use, and pain. Veterans with deployment TBI were also more likely to have a diagnosis of bipolar, major depressive, alcohol use, and posttraumatic stress disorders than those who did not have a deployment TBI.
CONCLUSIONS: TBIs acquired during deployment are associated with different behavioral and health outcomes than TBI acquired in non-deployment environments. The presence of TBI during deployment is associated with poorer behavioral outcomes, as well as a greater lifetime prevalence of behavioral and health problems in contrast to veterans without deployment TBI. These results indicate that problems may persist chronically following a deployment TBI and should be considered when providing care for veterans. Veterans with deployment TBI may require treatment alterations to improve engagement and outcomes.