A french version of the OSU TBI-ID for screening TBI in PTSD Military personnel

The co-occurrence of Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) is common in military personnel, leading to complex clinical challenges and poor prognosis. To enhance the care of PTSD patients, a TBI screening protocol was developed at a French Military Training Hospital (MTH). The Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID), a self-administered questionnaire, was translated into French (OSU TBI-ID Fr) to help standardize screening. This study aims to evaluate the feasibility and tolerance of the TBI screening protocol, to explore its potential to improve clinical outcomes for military personnel suffering from PTSD, and to assess TBI prevalence in our population.

This observational, retrospective, monocentric study was conducted at the MTH psychiatric unit. PTSD military personnel and veterans were screened for TBI using three questionnaires: OSU TBI-ID Fr, the PTSD Checklist for DSM-5 (PCL5), and the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). Data on patient characteristics and screening results were extracted from medical records to determine TBI prevalence. Feasibility was assessed based on the proportion of eligible patients who underwent screening, with reasons for non-participation documented. Tolerance was evaluated by recording side effects. Exploratory analyses included subgroup comparisons based on TBI or Repeated subconcussive Head Impacts (RHI) and correlations between PCL5 and RPQ scores.

Of the 233 PTSD patients treated in the psychiatry unit, 14.1% (n=33) completed the TBI screening between September 2022 and March 2023. Among the screened patients, 39.4% (n=13) had a history of TBI, and 48.5% (n=16) had been exposed to RHI. Three participants reported anxiety while completing OSU TBI-ID Fr. The average PCL5 score was 45.8, and the average RPQ score was 25.7. The main barriers to screening in the rest of the eligible population were lack of time, oversight, and interview setting (e.g., teleconsultation).

This study introduces the French version of the OSU TBI-ID as a standardized TBI screening tool for military personnel with PTSD. The high prevalence of undiagnosed TBI, often discovered through screening, highlights the importance of early detection. This study demonstrates the acceptability and tolerance of the OSU TBI-ID Fr in this population and suggests its potential to improve care by enabling earlier TBI identification. Future research should focus on refining the protocol, enhancing its applicability across settings, and optimizing integrated care pathways to improve clinical outcomes.