[A role of traumatic brain injury in the dynamics of combat posttraumatic stress disorder]

To explore dynamics of clinical signs of posttraumatic stress disorder (PTSD) and their causal relationship with organic brain changes.

A longitudinal observational study of 87 combatants of the Karabakh war (1992-1994) was conducted in 2009-2011. Two groups of patients were singled out. The first group included 45 veterans with mild combat cranial/brain injury with the following development of PTSD; the second group consisted of 42 veterans with organic brain lesions of traumatic origin. Somatic and neurological examination of patients and evaluation of their status using psychometric and other scales (CAPS, the Mississippi Scale for Combat-Related PTSD) were performed.

The analysis of patient's status at examination period and at the moment of injury demonstrated that PTSD patients, despite the relative reduction of posttraumatic symptoms, had higher level of all PTSD symptoms during the whole period of the disease (15-18 years) with the simultaneous aggravation of organic mental symptoms. In patients with organic brain lesions, the symptoms were more pronounced immediately after the traumatic event compared to the period of observation.