Overlap of mild TBI and mental health conditions in returning OIF/OEF service members and veterans.

Since October 2001, approximately 1.64 million U.S. troops have been deployed to Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) in Iraq and Afghanistan, with many exposed to prolonged periods of deployment-related stress and traumatic events. The RAND Corporation recently conducted a survey of 1,965 service members from 24 communities across the country to assess their exposure to traumatic events and possible brain injury while deployed and to evaluate their current symptoms of psychological illness [1]. Exposure to significant trauma was common. At least 50 percent reported that they had a friend who was seriously wounded or killed, 45 percent reported that they saw dead or seriously injured noncombatants, and over 10 percent reported that they were injured and required hospitalization. Frequency of trauma events was found to be even more common in a New England Journal of Medicine study [2], in which over 90 percent of service members returning from Iraq reported seeing dead bodies or human remains and over 50 percent reported being responsible for the death of an enemy combatant. The RAND survey found that 18.5 percent of all returning service members met criteria for either posttraumatic stress disorder (PTSD) or depression; these numbers are similar to those reported by Hoge and colleagues [3]. In addition, the RAND survey found that 19.5 percent reported experiencing a probable mild traumatic brain injury (TBI) during deployment; of those experiencing TBI, over a third also had overlapping PTSD or depression. Based on these survey results, the RAND Corporation estimated that approximately 300,000 service members who have returned from Iraq and Afghanistan are currently experiencing from PTSD or major depression and about 320,000 may have experienced at least a mild TBI during deployment.