Symptoms of traumatic encephalopathy syndrome are common in the US general population

Abstract

There are no validated criteria for diagnosing chronic traumatic encephalopathy, or traumatic encephalopathy syndrome, in a living person. The purpose of this study is to examine symptom reporting resembling the research criteria for traumatic encephalopathy syndrome in men and women from the US general population. This is a retrospective analysis of publicly available data from a cross-sectional epidemiological study. The National Comorbidity Survey Replication was designed to examine the prevalence and correlates of mental disorders in the United States. The study included a nationally representative sample of 9,282 adults (4,139 men and 5,143 women). An in-person interview and survey were conducted in the homes of men and women from the general population. The study was conducted with participants residing in New York City, Los Angeles, Chicago, Philadelphia, Detroit, San Francisco, Washington DC, Dallas/Fort Worth, Houston, Boston, Nassau-Suffolk NY, St Louis, Pittsburgh, Baltimore, Minneapolis, and Atlanta. Symptoms from the research criteria for the diagnosis of traumatic encephalopathy syndrome were applied to men and women in the general population and in subgroups of people with health problems and mental health problems. A small percentage of the US general population met symptom criteria for traumatic encephalopathy syndrome (6.6-11.9%, depending upon the definition applied). People with chronic pain were much more likely to meet criteria (i.e., 14.8% to 30.5%), and two out of three people who have experienced suicidality in the past year met symptom criteria for traumatic encephalopathy syndrome (65.2-72.2%). The majority of women with a mood disorder and chronic pain met criteria (62.7%-89.8%). This is the largest study to date examining aspects of the research criteria for the diagnosis of traumatic encephalopathy syndrome in the general population, and the first study to examine these criteria in women. This study has important clinical and public health implications. The potential rate for misdiagnosing traumatic encephalopathy syndrome in adults who are experiencing chronic pain, idiopathic mental health problems, or both is high.

Traumatic Encephalopathy Syndrome in the Late Effects of Traumatic Brain Injury (LETBI) study cohort

“…It has been previously established that the clinical features of TES are common in clinical and community samples, 17,41,42 but many prior studies were limited by lack of head trauma exposure data. Current findings indicate that the core clinical features of TES are highly prevalent among those with isolated TBI.…”

A narrative review of psychiatric features of traumatic encephalopathy syndrome as conceptualized in the 20th century

“…They used the preliminary 2014 research criteria (35) as the foundation for their work. Those 2014 criteria were broad, heavily focused on psychiatric problems, and several studies illustrated problems with applying the diagnostic criteria and their associated risk for misdiagnosis (62)(63)(64)(65). The core features of the 2014 criteria included depression (e.g., major depressive disorder), anger dyscontrol (e.g., intermittent explosive disorder), and cognitive impairment (e.g., mild cognitive impairment or dementia).…”

Medical Conditions in Former Professional American-Style Football Players Are Associated With Self-Reported Clinical Features of Traumatic Encephalopathy Syndrome

“… 6 As acknowledged by the authors, however, these studies lacked some components of past iterations of the TES criteria. 7 , 8 Given that general population studies have documented perceived cognitive difficulties and neurobehavioral dysfunction in persons with concurrent psychological (e.g., depression) and cardiovascular disorders (e.g., hypertension), identifying treatable conditions that are associated with TES clinical criteria could offer avenues of symptom reduction while TES treatments are developed.…”