Study: Soldiers' Very Early Post-Concussive Symptoms May Indicate Long Term Injury

A study out of Washington University School of Medicine in St. Louis may be a key to better understanding long-term neurological and psychological syndromes that soldiers of war face, particularly Post-Traumatic Stress Disorder, a group of symptoms first identified in soldiers returning from Vietnam. However, recent research shows that evidence suggests it's been around for thousands of years. It also can happen to victims of sexual assault, other assaults, violent injuries, or anyone who is around death and mayhem frequently, such as inner-city police officers and EMS responders.

However, post-concussive symptoms, such as seen after-blast injuries that soldiers face, may have especially severe sequelae following their injury. Some of the early symptoms they face may be anxiety, emotional numbness, flashbacks, and irritability, and those same symptoms are also the strongest predictors of long-term disability, the study suggests.

However, research also suggests that athletes such as football players may experience long term-neurological changes due to repeated concussion, and while that syndrome is not labeled PTSD, it is fraught with its own terrifying consequences, similar to that of PTSD -- namely suicidal ideation and severe clinical depression.

David L. Brody, M.D., Ph.D., associate professor of neurology at Washington University, said the results of the study were somewhat surprising to experts in the mental health field.

"Symptoms of post-traumatic stress and depression have always been thought to develop months to years later. We don't know what causes these symptoms, whether they result from the brain injury itself, from the stress of war or some combination of factors. But regardless of their origin, the severity of these psychological symptoms soon after injury was the strongest predictor of later disability."
Christine L. MacDonald, Ph.D., one of the authors for the study, said the study was the first of its kind to look at certain features.
"When we were able to connect the dots, we saw that injuries that might have been considered trivial seemed to have a big impact on how these patients did later on. Most previous studies have hypothesized that things such as duration of loss of consciousness, duration of post-traumatic amnesia and how well patients could perform tasks of thinking, memory, attention, balance and coordination would be the predictors of later disability. We looked at these factors. And they were not strongly correlated with how well patients did long term."
This is important because it suggests that military personnel need to be screened much earlier and treated for initial symptoms that were formerly thought to have less significance. More studies in this area will also assist with diagnosing and treating civilian trauma, MacDonald suggests, such as those found in football players.