Combat PTSD vs. Concussion: Unraveling Long-Term Effects and Implications for Soldiers’ Mental Health

According to a report published in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals, the effects and implications of combat-related post-traumatic stress disorder (PTSD) symptoms include longer-term physical symptoms such as headaches and tinnitus, as well as emotional issues like irritability and cognitive problems such as diminished concentration or memory. In contrast, soldiers who experience mild traumatic brain injuries (MTBI) or concussions generally do not face long-term consequences.

The authors provide background information on the deployment of over 2 million troops to Operation Enduring Freedom and Operation Iraqi Freedom since 2001, highlighting the effects and implications on soldiers’ mental health.

Operation Enduring Freedom/Operation Iraqi Freedom-deployed soldiers experienced high levels of combat exposure, increasing their risk of blast injuries and post-deployment mental and physical health problems.

Effects and Implications: Examining Concussion’s Long-Term Impact on PTSD Among Returning Soldiers

Despite the Department of Defense and Veterans Administration’s strong emphasis on early concussion identification, few studies have examined the long-term functional effects of concussion on returning soldiers.

953 combat-deployed U.S. National Guard soldiers were surveyed by Melissa A. Polusny, Ph.D., of the Minneapolis Veterans Affairs Health Care System and the University of Minnesota Medical School, Minneapolis, and colleagues to investigate the relationships between concussion and PTSD symptoms reported during deployment and long-term psychosocial outcomes.

“92.5% of participants were men, 87.1% white, 46.4% under 30, and 86.5% enlisted, matching Iraq infantry demographics.”

In Iraq, soldiers were polled both a month before they left for home and again a year afterward.
7.6% of all participating soldiers satisfied the criterion for probable PTSD at the time of the initial survey.

By the time of the second study, this percentage had risen to 18.2 percent.

“There was no difference in PTSD symptom changes between those with and without concussions from the first survey.”

Unraveling the Link: PTSD, Concussions, and Long-Term Impacts

“PTSD symptoms from the first survey strongly predicted post-deployment issues like concentration difficulties, memory problems, and impatience.”
“In the first poll, 9.2% reported concussions; by the second survey, this number increased to 22%.”
“By the second survey, 30.2% of those with a prior concussion had likely developed PTSD.” “Additionally, 30.4% of those reporting concussions in the second poll also had probable PTSD at that time.”

After deployment, soldiers with concussion histories often report symptoms. However, considering PTSD symptoms, the link becomes insignificant. Combat PTSD links to post-concussive symptoms and outcomes, but concussion’s long-term impact is minimal when factoring in PTSD.

These findings and the two-fold increase in reports of deployment-related concussion/MTBI history have important implications for screening and treatment.”