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Reviews
Published: 2020-07-05

Some socio-demographic and medical-anamnestic features of veterans with PTSD and TBI

I. Horbachevsky Ternopil National Medical University
post-traumatic stress disorder mild traumatic brain injury socio-demographic factors medical-anamnestic factors

Abstract

Objective. Veterans' mental health has been the subject of extensive research in many parts of the world. Particular attention is paid to PTSD, including in combination with trauma. Such comorbid conditions have a significant negative psychosocial impact, reducing the possibility of successful adaptation and resocialization of veterans. Certain features of socio-demographic and medical-anamnestic characteristics of veterans with PTSD, comorbid with TBI, as well as their problematic perception of certain areas of their lives may affect the formation of mental disorders, the course, and prognosis, success of therapy and rehabilitation, as well as recovery and quality of life. Thus, there is a need to study the characteristics of socio-demographic and medical-anamnestic characteristics of veterans with PTSD, especially in combination with CHD, to optimize pharmacological treatment and psychosocial therapy.

Purpose: to investigate the socio-demographic, medical, and anamnestic characteristics of veterans with PTSD and CHD.

Methods and materials. 329 combatants (members of the Armed Forces, the National Guard, and "volunteer battalions") in Eastern Ukraine who suffered from PTSD and LCHMT were examined. The socio-demographic and medical-anamnestic examination was performed using the Unified map of patient research developed by us.

Results. Analysis of the socio-demographic characteristics of patients with PTSD and TBI shows that about a third of those surveyed gained primary adult life experience in a military conflict. Stay in the combat zone affected the work history: before entering the service in the ATO, most of the surveyed persons worked full time in the civilian sphere, and after being in the ATO, these figures decreased by more than 3 times due to redistribution in the category of those who continued to serve. The large number of people who continued to serve despite receiving PTSD, TBI, or a combination of these can be partly explained by the desire to maintain "fraternal unity" as a surrogate family. Most of the subjects were premorbidly psychosomatically healthy despite periodic alcohol consumption; somatic vulnerability was unique to TBI individuals.

Conclusions. The socio-demographic, medical, and anamnestic features of veterans with PTSD and LCHMT identified by us were further used to form targets for psychosocial therapy and optimize pharmacological treatment.

Background

Modern macro- and micro-social factors related to the military conflict in eastern Ukraine have led to the transformation of public consciousness and changes in the lives and values ​​of millions of people, which is essentially a collective trauma [1-3]. Mental maladaptation as a result of the influence of these factors leads to the development of social stress disorders, which in ICD-10 are defined under the diagnostic heading "Neurotic, stress-related and somatoform disorders" (F40-F49) [1,3-5]. Among them, the clinical manifestations of PTSD most pronouncedly affect the psychological and social side of the individual's life, the level of their adaptive capabilities, the use of psychological resources to overcome stress, the functional level of psychological homeostasis [1,5,6].

The study of various aspects of the relationship between traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) in patients injured by military trauma has become particularly relevant because these disorders often coexist clinically, both individually and collectively, are considered as significant factors of health disorders in people affected by emergencies [2,7-12].

Occurrence and severity of adaptation disorders and post-traumatic stress development caused by social stress factors due to personal, neurobiological, and social factors: individual thinking, level of education, previous traumatic experience, psychophysical education, social and family status, social and family somatic diseases in the past [1,4,5].

Military trauma has a significantly destructive impact on the individual life of a citizen and the functioning of the society in which one is and brings socio-economic disruption at the state level. The most pressing issues of social rehabilitation of victims of military trauma are the restoration of civilian status, the implementation of social contacts in peace, the constructive overcoming of socio-economic difficulties, correction of alcohol and psychoactive substance abuse, replacement of destructive behavioral strategies with more socially desirable and individually useful [1-3,5,12-14].

Veterans' mental health has been the subject of extensive research in many parts of the world. Particular attention is paid to PTSD, including in combination with TBI. Such comorbid conditions have a significant negative psychosocial impact, reducing the possibility of successful adaptation and resocialization of veterans. Certain features of socio-demographic and medical-anamnestic characteristics of veterans with PTSD comorbid with slight traumatic brain injury, as well as their problematic perception of certain areas of their lives may affect the formation of mental disorders, the course, and prognosis, success of therapy and rehabilitation, as well as recovery and quality of life [1-3,5,12-14].

Thus, there is a need to study the characteristics of socio-demographic and medical-anamnestic characteristics of veterans with PTSD, especially in combination with slight traumatic brain injury (STBI), their relationship with the clinical characteristics of victims in order to optimize pharmacological treatment and psychosocial therapy.

Aim

The aim of the study is to investigate the socio-demographic, medical, and anamnestic characteristics of veterans with PTSD and slight traumatic brain injury (STBI).

Methods and materials

329 combatants (members of the Armed Forces, the National Guard, and "volunteer battalions") in eastern Ukraine who suffered from PTSD and STBI were examined. The study was conducted on the basis of the Municipal Non-Commercial Enterprise "Ternopil Regional Clinical Psychoneurological Hospital" of the Ternopil Regional Council, where this contingent underwent treatment and/or rehabilitation.

The examination was conducted using our Unified Patient Study Card, which included the collection of information on certain socio-demographic and medical-social indicators, namely: age, gender, marital status, education, employment status, disability, living conditions, stay in the ATO area, duration of direct stay in the combat zone, duration of demobilization, military rank.

Results

The study material was structured within three research groups (Table 1): groups of veterans diagnosed with post-traumatic stress disorder (PTSD group) - 109 people (33.1% of the surveyed contingent); groups of veterans with the consequences of traumatic brain injury (group TBI) - 112 people (34.0%); groups of veterans with PTSD with comorbid consequences of traumatic brain injury (group of CTBI) - 108 people (32.8%).

Group Total φ*
Indicator abs. %
PTSD 109 33.1 0.7238
TBI 112 34.0 0.4439
CTBI 108 32.8 0.3219
Total 329 100.0 -
Table 1. Distribution of the contingent by research groups and gender

According to the results of the comparison of the volumes of the selected groups, performed using the calculation of the coefficient Fisher's φ * - angular transformation (Table 1), no statistical difference in the number of respondents who made up the research groups was found (φ * ≤0.723; p> 0.1). Thus, research groups can be considered representative and statistically comparable.

The studied contingent consisted of persons aged 19 to 64 years. The structuring of research groups by age intervals at 10 years was unreliable (φ * ≤1,623; p> 0,1), which indicates the harmony of the distribution of respondents in the research groups by age and the irrationality of the use of age in further research (Table 2).

At the same time, we can testify that about a third of the surveyed persons significantly gained primary adult life experience in the conditions of military conflict (37.98% of representatives of all research groups were under the age of 30).

Group PTSD TBI CTBI
Indicator abs. % φ* abs. % φ* abs. % φ*
Age characteristics
<20 3 2.75 1.482 3 2.67 1.623 3 2.77 1.592
21-30 36 33.03 - 41 36.61 0.331 39 36.11 0.335
31-40 36 33.03 0.406 37 33.04 0.478 35 32.41 0.326
>40 31 28.44 1.309 31 27.68 1.623 31 28.7 1.592
Was brought up in childhood
By full family 51 46.79 0.716 51 45.54 0.443 58 53.7 1.797
By 1 of the parents 43 39.45 2.115 46 41.07 2.129 38 35.19 1.559
By grandmother, grandfather 10 9.174 0.428 6 5.35 0.134 3 2.77 0.069
By other relatives 3 2.752 0.067 4 3.57 0.067 4 3.71 0.069
By orphanage 2 1.835 1.713 5 4.46 2.252 5 4.63 2.599
Education
Secondary 13 11.93 2.643 12 10.71 2.477 12 11.11 2.667
Secondary-special 52 47.71 0.722 50 44.64 - 52 48.15 0.728
Higher 44 40.37 2.127 50 44.64 2.477 44 40.74 2.164
Work before the anti-terrorist operation
Did not work 29 26.61 0.159 33 29.46 0.079 28 25.93 0.239
Part-time employment 31 28.44 0.654 32 28.57 0.401 31 28.7 0.659
Full employment 39 35.78 1.881 37 33.04 1.733 39 36.11 1.893
Continued to serve 10 9.174 1.277 10 8.92 1.497 10 9.25 1.222
Work after the anti-terrorist operation
Did not work 33 30.28 0.081 34 30.36 0.079 32 29.63 -
Part-time employment 32 29.36 1.384 33 29.46 1.425 32 29.63 1.393
Full employment 12 11.01 1.384 12 10.71 1.425 12 11.11 1.393
Continued to serve 32 29.36 0.081 33 29.46 0.079 32 29.63 -
Marital status
Single 36 33.03 1.935 37 33.04 1.998 35 32.41 2.026
Married 58 53.21 3.021 60 53.57 3.093 58 53.7 3.042
Divorced 15 13.76 1.511 15 13.39 1.552 15 13.89 1.45
Table 2. Basic sociological characteristics with the results of Fisher's φ * - angular transformation

The vast majority of surveyed persons in childhood were brought up in complete families, but this predominance is significant only for the CTBI group - 53.7% (φ * = 1,797; р≤0,036). A significant majority of people raised in single-parent families were in the PTSD group - 39.5% (φ * = 2.115; p≤0.016), in the TBI group - 41.1% (φ * = 2.129; p≤0.016). A statistically significant minority of respondents from all research groups were brought up in orphanages as children (φ * ≥1,713; р≤0,044).

In all three research groups, the share of people with secondary education was significantly the lowest (respectively in the PTSD group - 11.9% (φ * = 2,643; р≤0,003), in the TBI group - 10.7% (φ * = 2,477; р≤ 0.02), in the CTBI group - 11.1% (φ * = 2.667; p≤0.002) there were relatively significantly more people with higher education, they were respectively in the group of PTSD - 40.1% (φ * = 2.127; p≤0,017), in the group of TBI - 44.6% (φ * = 2,477; p≤0,005), in the group of CTBI - 40.7% (φ * = 2,164; p≤0,015). The rest of the persons had secondary special education. Thus, we can attest to a fairly high level of education of individuals in all groups studied.

Prior to joining the anti-terrorist operation, most of the surveyed persons worked full-time in the civilian sphere (respectively in the PTSD group - 35.8% (φ * = 1.881; p≤0.03), in the TBI group - 33.04% * = 1,733; р≤0,042), in the CTBI group - 36.11% (φ * = 1,893; р≤0,029). After being in the ATO, these figures decreased by more than 3 times due to the redistribution in the category of those who continued to serve.

According to a marital status, about half of the surveyed persons were married (respectively in the group of PTSD - 53.2% (φ * = 3,021; p <0,0001), in the group of TBI - 53.6% (φ * = 3,093; p <0, 0001), in the group of CTBI - 53.7% (φ * = 3,042; p <0,0001). However, the second half of the respondents did not have a relevant family, and in all groups, more than 2/3 were singles, and 1/3 – divorced. Thus, we can attest that the unexpectedly large number of people who continued to serve despite receiving PTSD, TBI, or a combination of these can be partly explained by the desire to maintain "fraternal unity" as a surrogate family.

According to military ranks, the structure of all research groups was homogeneous (φ * ≤0.663; p> 0.1): private soldiers, sergeants, and officers accounted for one-third of the surveyed contingent (Table 3).

Group PTSD TBI CTBI
Indicator abs. % φ* abs. % φ* abs. % φ*
Military rank
Private soldier 41 37.61 0.502 45 40.18 0.906 42 38.89 0.754
Sergeant 35 32.11 0.163 34 30.36 0.079 33 30.56 -
Officer 33 30.28 0.663 33 29.46 0.984 33 30.56 0.754
General conscription or contract service
General conscription 71 65.14 3.061 68 60.71 2.232 78 72.22 4.288
Contract service 38 34.86 3.061 44 39.29 2.232 30 27.78 4.288
Length of stay in the combat zone
up to 1 week 19 17.43 1.055 11 9.82 0.826 19 17.59 0.986
up to 1 month 33 30.28 0.627 23 20.54 0.761 32 29.63 0.552
up to 3 months 25 22.94 0.304 33 29.46 - 25 23.15 0.306
up to 6 months 21 19.27 0.704 33 29.46 1.425 21 19.44 0.708
up to 1 year 11 10.09 0.567 12 10.71 0.071 11 10.19 0.57
Table 3. Additional characteristics with the results of Fisher's φ * - angular transformation

The vast majority of respondents in all research groups during hostilities served in the conscription (φ * ≥3,042; р≤0,013): 71 people (65.14%) in the PTSD group; 68 people (60.71%) in the TBI group and 78 people (72.22%) in the CTBI group.

The duration of the stay in the combat zone was structured as follows: up to 1 week; up to 1 month; up to 3 months; up to 6 months and up to 1 year. When comparing groups of percentages of the number of respondents in the research groups within these terms using the calculation of the coefficient Fisher's φ * - angular transformation, no statistically significant difference was found (φ * ≤1,425; p≥0,078), which indicates a harmonious distribution research material and this important factor.

The analysis of additional medical and anamnestic characteristics of the respondents of the studied groups gave the following results (Table 4).

Group PTSD TBI CTBI
Indicator abs. % φ* abs. % φ* abs. % φ*
Treatment by a psychiatrist before service in the anti-terrorist operation
no 86 78.9 5.250 88 78.57 5.282 86 79.63 5.31
yes 23 21.1 5.250 24 21.43 5.282 22 20.37 5.31
Chronic somatic diseases before service in the anti-terrorist operation
no 49 44.95 1.05 45 40.18 2.051 67 62.04 2.45
yes 60 55.05 1.05 67 59.82 2.051 41 37.96 2.45
Disability group
yes 34 31.19 3.731 84 75.0 4.798 39 36.11 2.81
no 75 68.81 3.731 28 25.0 4.798 69 63.89 2.81
Alcohol consumption
Does not use 14 12.84 2.231 18 16.07 2.036 20 18.52 2.141
Several times/year 46 42.2 1.168 46 41.07 1.144 48 44.44 1.5
1 time/month 32 29.36 1.337 32 28.57 1.315 30 27.78 1.405
2 times/month 13 11.93 0.559 13 11.61 0.572 8 7.41 0.352
1 time/week 4 3.67 0.613 3 2.67 0.795 2 1.85 0.832
Cannabinoid use
Does not use 66 60.55 3.341 68 60.71 3.507 69 63.89 3.767
Several times/year 25 22.94 0.918 23 20.54 0.707 21 19.44 0.708
1 time/month 12 11.01 0.459 13 11.61 0.512 11 10.19 0.449
2 times/month 5 4.587 0.218 5 4.464 0.132 4 3.70 0.069
1 time/week 1 0.917 1.579 3 2.679 2.471 3 2.77 2.573
Use of other psychoactive substances
Did not use 65 59.63 3.104 97 86.61 5.375 69 63.89 3.709
Opiates 28 25.69 1.201 10 8.92 0.398 23 21.3 0.994
Psychostimulants 3 2.752 0.068 1 0.89 - 8 7.407 0.206
Hallucinogens 4 3.67 0.136 1 0.89 0.064 5 4.63 0.22
Barbiturates 6 5.505 0.198 2 1.78 0.064 1 0.926 -
Tranquilizers 3 2.752 2.423 1 0.89 2.191 1 0.926 -
Others - - - - - - 1 0.926 1.648
Table 4. Additional medical and anamnestic characteristics with the results of Fisher's φ * - angular transformation

In all groups, a significant majority of respondents (φ * ≥5.25; p <0.0001) never sought psychiatric care before being in the combat zone: 86 people (78.9%) in the PTSD group; 88 people (78.57%) in the TBI group and 86 people (79.63%) in the CTBI group.

A completely different picture was observed with anamnestic data on chronic somatic diseases. In the PTSD group, there was no statistically significant difference between the number of people treated for these diseases before participating in the anti-terrorist operation and those who had not previously suffered from chronic somatic diseases (φ * = 1.05; p> 0.1), while in the group of TBI the majority was treated for these diseases (φ * = 2,051; p <0,02), and in the group of CTBI, on the contrary, the majority was treated for chronic somatic diseases (φ * = 2,45; p < 0.005).

At the time of the survey, a significant majority of the disability group did not have (φ * ≥2.81; p≤0.001) respondents from the PTSD group (75 people - 68.81%) and CTBI (69 people - 63.89%), while in the group of TBI, on the contrary, the majority was with a disability group (φ * = 4.798; p <0.0001) (84 people - 75.0%).

The results of the survey on alcohol use indicate that a significant minority of all study groups abstain from alcohol consumption (φ * ≥2,036; р≤0,021). However, statistically significant differences in the rhythm of alcohol consumption (Table 4) were not detected (φ * ≤1,405; p≥0,081).

The analysis of the results of the survey of the second, most popular psychoactive substance among the participants of the armed conflict in eastern Ukraine - the group of cannabinoids, gave opposite results - a statistically significant majority of respondents did not use them (φ * ≥3,341; p <0,0001). Among cannabinoid users, as in the case of alcohol, it was not possible to identify a group with one or another rhythm of drug use (φ * ≤1,579; p≥0,056) except for members of the TBI group - the rhythm of use "once a week and more often" was found in the significant (φ * = 2,471; p <0,006) minority of respondents (3 persons - 2.68%).

Other psychoactive substances according to the results of the survey were also never used by the majority of all research groups (φ * ≥3.104; p <0.0001). Among respondents who used other surfactants, opiate users predominated (28 people - 25.69% in the PTSD group; 10 people - 8.92% in the TBI group; 23 people - 21.3% in the CTBI group), although the statistical significance of this the advantage is not acceptable (φ * ≤1,201; p> 0,1).

To check the differences in the percentages of the number of respondents of individual research groups, which are characterized by the above-described social and anamnestic factors, we also calculated the coefficient Fisher's φ * - angular transformation (Table 5-6), based on the analysis of which to state that there is no statistically significant difference between patients who made up the groups of PTSD, TBI and CTBI (φ * ≤1.559898; p> 0.61). The only exception is the number of people who did not use other surfactants - there were significantly more of them in the group significantly more among the TBI group (φ * ≥3.429138; p <0.0001), while between the number of such persons in the PTSD and CTBI groups no significant difference was found (φ * ≥0.507329; p> 0.1).

Group PTSD-TBI PTSD-CTBI TBI - CTBI
Age characteristics
<20 0.006034 0.001495 0.00753
21-30 0.329111 0.280263 0.04647
31-40 0.000908 0.055668 0.056944
>40 0.066598 0.022659 0.089257
Was brought up in childhood
By full family 0.12662 0.720519 0.851142
By 1 of the parents 0.155735 0.395756 0.552648
By grandmother, grandfather 0.287783 0.426895 0.187251
By other relatives 0.061341 0.071129 0.010572
By orphanage 0.183849 0.193604 0.012905
Education
Secondary 0.096219 0.064168 0.031429
Secondary-special 0.310956 0.04491 0.355424
Higher 0.418008 0.035346 0.381552
Work before the anti-terrorist operation
Did not work 0.249356 0.058318 0.307155
Part-time employment 0.011427 0.022659 0.011411
Full employment 0.25136 0.030369 0.281327
Continued to serve 0.0198 0.005876 0.025676
Work after the anti-terrorist operation
Did not work 0.007122 0.057197 0.064682
Part-time employment 0.008846 0.023683 0.015019
Full employment 0.023619 0.00781 0.031429
Continued to serve 0.008846 0.023683 0.015019
Marital status
Single 0.000908 0.055668 0.056944
Married 0.039191 0.052901 0.014157
Divorced 0.029584 0.010315 0.039898
Table 5. Indicators of Fischer’s φ * - angular transformation obtained by comparing the main social characteristics of the studied groups.
Group PTSD-TBI PTSD-CTBI TBI - CTBI
Military rank
Private soldier 0.244205 0.119969 0.122979
Sergeant 0.156827 0.137726 0.017783
Officer 0.072777 0.024722 0.097499
General conscription or contract service
General conscription 0.54077 0.932009 1.474477
Contract service 0.414331 0.625943 1.033198
Length of stay in the combat zone
up to 1 week 0.590949 0.012976 0.602061
up to 1 month 0.827066 0.057197 0.769899
up to 3 months 0.560188 0.017631 0.54138
up to 6 months 0.854564 0.013943 0.839149
up to 1 year 0.048662 0.007769 0.040726
Alcohol consumption
Does not use 0.258134 0.449979 0.199501
Several times / year 0.109938 0.219111 0.330212
1 time / month 0.069666 0.137638 0.069105
2 times / month 0.025317 0.342581 0.320482
1 time / week 0.074962 0.13008 0.060687
Cannabinoid use
Does not use 0.018953 0.400205 0.384082
Several times / year 0.201452 0.289564 0.091138
1 time / month 0.047327 0.063825 0.111279
2 times / month 0.009356 0.06644 0.057619
1 time / week 0.118661 0.123502 0.006846
Use of other psychoactive substances
Didn’t use 3.916171 0.507329 3.429138
Opiates 1.239097 0.368309 0.931477
Psychostimulants 0.125022 0.321928 0.341589
Hallucinogens 0.175815 0.071871 0.223453
Barbiturates 0.252345 0.260076 0.061135
Tranquilizers 0.125022 0.121735 0.002684
Others - 1.559898 -
Table 6. Indicators of Fisher's φ * - angular transformation obtained by comparing additional sociological characteristics of the studied groups

There were also significant differences when comparing the number of respondents in the PTSD and CTBI groups who suffered from chronic somatic diseases before serving in the ATO - in the CTBI group there were significantly more (φ * ≥1,168; p <0,046) of them. There were significantly more people with a disability group in the TBI group than in the PTSD and CTBI groups (φ * ≥3.593094; p <0.0001), with no differences in the number of respondents with disabilities in the PTSD and CTBI groups (φ * ≤0.624587; p> 0.1) (Table 7).

Group PTSD-TBI PTSD-CTBI TBI - CTBI
Treatment by a psychiatrist before service in the anti-terrorist operation
no 0.053188 0.118081 0.171946
yes 0.027639 0.060383 0.088331
Chronic somatic diseases before service in the anti-terrorist operation
no 0.467438 1.831987 2.287443
yes 0.542994 1.699506 2.223479
Disability group
yes 4.47343 0.444048 4.154993
no 4.105761 0.624587 3.593094
Table 7. Indicators of Fisher's φ * - angular transformation obtained by comparing additional medical and anamnestic characteristics of the studied groups

Discussion

Acquisition of about a third of the surveyed persons in primary adult life experience in a military conflict (37.98% of all research groups were under the age of 30) can be considered an aggravating factor, potentially negatively affecting the process of returning to civilian life, with additional restrictions resilience due to PTSD and/or TBI. The study of van der Naalt J. et al. (2017) [15] and Haarbauer-Krupa J. et al. (2017)[16] also noted the aggravating role of younger age in the further course and effective recovery of patients with TBI and PTSD.

The redistribution of professional employment of the surveyed persons due to being in the combat zone is noteworthy: before entering the service in the anti-terrorist operation most of the surveyed persons worked in full employment in the civilian sphere (respectively in the PTSD group - 35.8% (φ * = 1,881; p ≤0.03), in the TBI group - 33.04% (φ * = 1,733; p≤0,042), in the CTBI group - 36.11% (φ * = 1,893; p≤0,029). After staying at ATO as mentioned above, these figures have more than tripled due to the redistribution of those who continued to serve. The unexpectedly large number of people who continued to serve despite receiving PTSD, TBI, or a combination of these can be partly explained by the desire to continue applying the acquired skills [15] and to a greater extent the preservation of "fraternal unity" as a surrogate family [16]. The latter phenomenon certainly plays a positive role in the psychological state of servicemen and volunteers under the battle, but mentally "keeps" veterans at war, slowing their adaptation to civilian life [1,3,4].

The anamnesis of alcohol consumption indicates that a significant minority of all study groups abstain from alcohol consumption (φ * ≥2,036; р≤0,021), while the use of other surfactants is much lower. There has been pointed out the predominance of alcohol use/abuse compared to other psychoactive substances by other researchers [17]. However, in some clinical groups, there were no statistically significant differences in the rhythm of alcohol consumption.

Almost 80% of those surveyed in all groups (φ * ≥5.25; p <0.0001) had never sought psychiatric care before being in the combat zone, while in the traumatic brain injury group the majority had been treated for chronic somatic diseases (φ * = 2,051; p <0,02), which was due to the participation in the fighting of volunteer battalions, which included older people with somatic burden [18].

Conclusion

1. Analysis of the socio-demographic characteristics of patients with PTSD and TBI shows that about a third of the surveyed persons gained primary adult life experience in a military conflict.

2. Staying in the combat zone affected the occupational anamnesis: before entering the service in the anti-terrorist operation most of the surveyed persons worked in full employment in the civilian sphere, and after being in the anti-terrorist operation these indicators decreased more than 3 times due to redistribution in the category of those continued to serve. The large number of people who continued to serve despite receiving PTSD, TBI, or a combination of these, can be partly explained by the desire to maintain "fraternal unity" as a surrogate family.

3. Most of the surveyed persons were premorbid psychosomatically healthy despite periodic alcohol consumption; somatic vulnerability was unique to individuals with TBI.

Additional information

Conflict of interests

The authors declare no competing interests exist.

References

  1. Matyash M, Khudenko L. Social stress disorders in the structure of ukrainian syndrome. UMJ. 2016;3(113):118-21.
  2. Smashna O, Khaustova O. Features posttraumatic stress disorder diagnosis in patients with mild traumatic brain injury. Archiv psychiatrii. 2017;23(4):225-32.
  3. Fang S, Schnurr P, Kulish A, et al. Psychosocial Functioning and Health-Related Quality of Life Associated with Posttraumatic Stress Disorder in Male and Female Iraq and Afghanistan War Veterans: The VALOR Registry. J Womens Health (Larchmt). 2015;24(12):1038-46. doi:https://doi.org/10.1089/jwh.2014.5096
  4. Nichter B, Norman S, Haller M, Pietrzak R. Psychological burden of PTSD, depression, and their comorbidity in the U. S veteran population: Suicidality, functioning, and service utilization J Affect Disord. 2019;256:633-640. doi:https://doi.org/10.1016/j.jad.2019.06.072
  5. Wang Y, Karstoft K, Nievergelt C. Post-traumatic stress following military deployment: Genetic associations and cross-disorder genetic correlations. J Affect Disord. 2019;252:350-357.
  6. Smashna O. Cognitive-behavioral therapy of the insomnia in posttraumatic stress disorders. Archiv psychiatrii. 2014;20(4):91-5.
  7. Khaustova O, Smashna O. Comorbidity of PTSD and TBI: multifactor model of interaction Archiv psychiatrii. 2016;22(1):22-7.
  8. DePalma R, Hoffman S. Combat blast related traumatic brain injury (TBI): decade of recognition; promise of progress. Behav Brain Res. 2018;340:102-5. doi:https://doi.org/10.1016/j.bbr.2016.08.036
  9. Vasterling J, Jacob S, Rasmusson A. Traumatic Brain Injury and Posttraumatic Stress Disorder: Conceptual, Diagnostic, and Therapeutic Considerations in the Context of Co-Occurrence. J Neuropsychiatry Clin Neurosci. 2018;30(2):91-100. doi:https://doi.org/10.1176/appi.neuropsych.17090180
  10. Dieter J, Engel S. Traumatic Brain Injury and Posttraumatic Stress Disorder: Comorbid Consequences of War. Neurosci Insights. 2019;14. doi:https://doi.org/10.1177/1179069519892933
  11. Pietrzak R, Johnson D, Goldstein M, Malley J, Southwick S. Posttraumatic stress disorder mediates the relationship between mild traumatic brain injury and health and psychosocial functioning in veterans of Operations Enduring Freedom and Iraqi Freedom. J Nerv Ment Dis. 2009;197(10):748-753.
  12. Shandera-Ochsner A, Berry D, Harp J, et al. Neuropsychological effects of self-reported deployment-related mild TBI and current PTSD in OIF/OEF veterans. Clin Neuropsychol. 2013;27(6):881-907.
  13. Dieter J, Engel S. The efficacy of a transdisciplinary intensive outpatient program for treating active duty service members with TBI and associated disorders. в: FY17 Prevention, Mitigation, and Treatment of Blast Injuries Report to the Executive Agent. US Department of Defense Blast Injury Research Program Coordinating Office.
  14. Smashna O. , Khaustova O. Diagnostic Approach to the Mild Traumatic Brain Injury Verification in Patients with Posttraumatic Stress Disorder Psychiatry, psychotherapy and clinical psychology. 2019;3:408-16.
  15. Matthieu M, Meissen M, Scheinberg A, Dunn E. Reasons why post–9/11 era veterans continue to volunteer after their military service. Journal of Humanistic Psychology. 2019;1(1).
  16. Hinojosa R, Hinojosa M. Using military friendships to optimize postdeployment reintegration for male Operation Iraqi Freedom/Operation Enduring Freedom veterans. J Rehabil Res Dev. 2011;48(10):1145-1158.
  17. Burnett-Zeigler I, Ilgen M, Valenstein M. Prevalence and correlates of alcohol misuse among returning Afghanistan and Iraq veterans. Addictive behaviors. 2011;36(8):801-806.
  18. Cymbaljuk V, Serdjuk A. Medychne Zabezpechennja antyterorystychnoi’ operacii’: Naukovo-Organizacijni Ta Medyko-social’ni Aspekty. NVC «Priorytety»; 2016.
  19. Sukyasjan S, Tadevosjan M. Rol’ cherepno-mozgovoj travmy v dynamyke boevogo posttravmatycheskogo stressovogo rasstrojstva. Zhurnal nevrologyy y psyhyatryy Korsakova. 2014;114(4):16-24.
  20. van der Naalt J, Timmerman M, de Koning M. Early predictors of outcome after mild traumatic brain injury (UPFRONT): an observational cohort study. Lancet Neurol. 2017;16(7):532-540.
  21. Haarbauer-Krupa J, Taylor C, Yue J. Screening for Post-Traumatic Stress Disorder in a Civilian Emergency Department Population with Traumatic Brain Injury. J Neurotrauma. 2017;34(1):50-58.

How to Cite

1.
Smashna О. Some socio-demographic and medical-anamnestic features of veterans with PTSD and TBI. PMGP [Internet]. 2020 Jul. 5 [cited 2024 Mar. 28];5(3):e0503264. Available from: https://e-medjournal.com/index.php/psp/article/view/264