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Intensive Outpatient Program Response Among Service Members With Mild Traumatic Brain Injury: Change Between Distinct

Adam R Kinney1, Rachel Sayko Adams2, Jesus J Caban3

  • 1VA Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC), Aurora, CO; University of Colorado, Anschutz Medical Campus, Department of Physical Medicine and Rehabilitation, Aurora, CO.

Archives of Physical Medicine and Rehabilitation
|January 13, 2023
PubMed
Summary
This summary is machine-generated.

Service members with mild traumatic brain injury (mTBI) showed symptom improvement in an intensive outpatient program (IOP). Those with posttraumatic stress disorder (PTSD) had fewer improvements, indicating a need for targeted care.

Keywords:
Brain injuriesMilitary personnelPost-concussion syndromePost-traumaticRehabilitationStress disordersTraumatic

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Area of Science:

  • Neuroscience
  • Military Medicine
  • Psychiatry

Background:

  • Mild traumatic brain injury (mTBI) is prevalent in service members (SMs).
  • Persistent post-concussive symptoms (PCSs) impact SMs despite treatment.
  • Identifying distinct symptom subgroups is crucial for tailored interventions.

Purpose of the Study:

  • To identify distinct subgroups of SMs based on PCSs.
  • To analyze transitions between these subgroups from admission to discharge in an intensive outpatient program (IOP).
  • To investigate the influence of comorbid posttraumatic stress disorder (PTSD) on these transitions.

Main Methods:

  • Quasi-experimental design utilizing latent transition analysis.
  • 1141 active duty SMs with persistent PCS were assessed.
  • Neurobehavioral Symptom Inventory items were used to define subgroups at admission and discharge.

Main Results:

  • Seven distinct subgroups of SMs were identified based on PCS patterns.
  • The 'Minimal' subgroup (low symptom burden) was most prevalent at discharge (39.4%).
  • SMs with comorbid PTSD were less likely to transition to the 'Minimal' subgroup and more likely to remain in their admission subgroup.

Conclusions:

  • Most SMs experienced symptom reduction after the IOP.
  • SMs in the 'Affective' and 'Sleep' subgroups, and those with PTSD, showed persistent clinical needs.
  • Findings highlight priority targets for resource allocation and follow-up care for SMs with mTBI and comorbid conditions.