Incidence of posttraumatic stress disorder and mild traumatic brain injury in burned service members: Preliminary report

Background: Although sustaining physical injury in theater increases service members' risk for posttraumatic stress disorder (PTSD), exposure to explosive munitions may increase the risk of mild traumatic brain injury (mTBI). We hypothesized a higher incidence of PTSD and mTBI in service members who sustained both burn and explosion injuries than in nonexplosion exposed service members. Methods: A retrospective review of PTSD and mTBI assessments was completed on burned service members between September 2005 and August 2006. Subjects were divided into cohort groups: (1) PTSD and mTBI, (2) PTSD and no mTBI, (3) mTBI and no PTSD, (4) no mTBI and no PTSD. Specific criteria used for group classification were based on subjects' total score on Posttraumatic Stress Disorder Checklist, Military version (PCL-M), clinical interview, and record review to meet American Congress of Rehabilitation Medicine criteria for mTBI. Descriptive analyses were used. Results: Seventy-six service members met the inclusion criteria. The incidence rate of PTSD was 32% and mTBI was 41%. Eighteen percent screened positive for PTSD and mTBI; 13% screened positive for PTSD, but not mTBI; 23% screened positive for mTBI but not PTSD; 46% did not screen positive for either PTSD or mTBI. Conclusion: Given the high incidence of these disorders in burned service members, further screening of PTSD and TBI appears warranted. Because symptom presentation in PTSD and mTBI is clinically similar in acute and subacute stages, and treatments can vary widely, further research investigating symptom profiles of PTSD and mTBI is warranted.