Features of functioning and quality of life of veterans with post-traumatic stress disorder and mild traumatic brain injury

Abstract

Background. The clinical triad of polytrauma of servicemen is determined by three comorbid diagnoses – consequences of traumatic brain injury TBI, chronic pain and post-traumatic stress disorder. Such multimorbidity affects the long-term results of treatment and rehabilitation of veterans. Purpose – to investigate the features of quality of life and functioning in patients with PTSD, mild TBI and comorbid pathology (PTSD+mTBI); to analyze the influence of the severity of symptoms and cognitive profile on indicators of functioning and assessment of quality of life (QL). Materials and Methods. 329 veterans with PTSD (n = 109), with mTBI (n = 112) and with comorbid PTSD + mTBI (n = 108) were examined. Assessment of disability according to WHO (WHODAS 2.0, version 12) was carried out. The severity of clinical symptoms was assessed by the Four-Dimensional Symptom Questionnaire (4DSQ). Cognitive functioning was studied using a set of psychodiagnostic methods – the Rey–Osterritz test, Trail making test, Verbal fluency test, and the Stroop test. QLwas assessed using the Quality of Life Assessment Scale (by O. Chaban). Results. Veterans with PTSD with pronounced emotional and cognitive symptoms were more satisfied with the level of social activity, which is possible assume a partially compensatory mechanism of social interaction in emotional disorders. A more pronounced relationship between cognitive functioning and QL is observed in mTBI. In the PTSD + mTBI multimorbid pathology group, individuals with more pronounced «intrusion» symptoms and a greater sense of distress had a significantly lower level of life satisfaction in general. Conclusions. Multimorbidity in the form of a combination of PTSD and mTBI in veterans led to a worse assessment of the quality of life compared to patients with monopathology (only mTBI or only PTSD).