The Deployment Trauma Phenotype and Employment Status in Veterans of the Wars in Iraq and Afghanistan.
The Deployment Trauma Phenotype and Employment Status in Veterans of the Wars in Iraq and Afghanistan.
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DOI：
10.1097/htr.0000000000000308
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
McGlinchey RE
中科院分区：
文献类型：
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作者：
Amick MM;Meterko M;Fortier CB;Fonda JR;Milberg WP;McGlinchey RE
To determine the prevalence of comorbid mild traumatic brain injury (mTBI), PTSD, and depression, termed the deployment trauma phenotype (DTP), and its constituent diagnoses' impact on unemployment status in a national cohort of veterans. Retrospective analysis of the comprehensive TBI evaluation, a VA-wide protocol for assessing TBI, employment status, and psychiatric impressions. The final dataset consisted of 48,821 veterans. Frequency of mTBI, PTSD, and depression in isolation and combinations and their association with unemployment status. Age- and education- adjusted risk ratios showed that the mTBI-only group was the least likely to be unemployed, RR = 0.65 [0.59, 0.71]. By contrast, the greatest likelihood of unemployment was associated with membership in the DTP group, RR =1.45 [1.36, 1.56] and the comorbid PTSD and Depression group, RR = 1.39 [1.27, 1.52]. Furthermore, the DTP was nearly three times more prevalent (16.4%) in this sample compared to comorbid PTSD and Depression (5.7%) indicating that the DTP conveys risk for unemployment to a significantly greater number of individuals. The co-morbid and interactive conditions of PTSD, depression, and mTBI, rather than mTBI in isolation, were linked to significant risk for unemployment in this veteran cohort. These findings suggest that multi-faceted assessments and interventions to improve post-deployment reintegration are needed.
