Mind-Brain Connection: PTSD and Concussions

The February 1st edition of the New England Journal of Medicine reports that suffering a concussion in Iraq after a bomb attack was strongly associated with post-traumatic stress disorder (PTSD).

Three to four months after returning home from Iraq, [2,525] soldiers completed an anonymous survey about their combat experiences, injuries, symptoms of PTSD, depression, and physical health problems.
Almost 15% of the soldiers had suffered a concussion in Iraq, including 5% who lost consciousness and 10% who were dazed and confused or saw stars. An additional 17% reported other injuries that didn’t involve concussions.
Nearly 44% of soldiers who lost consciousness were diagnosed with PTSD, compared with 27% of those who had concussions but remained conscious, 16% of soldiers with other injuries, and 9% of uninjured soldiers. Depression also often accompanied loss-of-consciousness concussions.
Soldiers who had suffered concussions also reported worse health and missed more days of work.

In a radio interview with CBC on January 31st, the lead researcher, Dr. Christian Hoge, pointed out that concussion, or mild traumatic brain injury, as it is often referred to these days, is not always associated with PTSD — for example, there is nothing pointing to sports-related concussions increasing the risk of PTSD. It is when the concussion occurs in connection with a life-threatening event that it is associated with PTSD.

It is going to be interesting to see what further research is spawned by this. For example, what are the implications for PTSD associated with sexual assault?

A quick review of internet and of the first “bible” on PTSD, Herman’s Trauma and Recovery, does not indicate any mention of this connection (maybe on closer reading it’s somewhere in there; I have to confess it’s been quite a while since I last read it).

In general, I always had the impression that traditional research does not pay much attention to the connection between physical and mental/emotional events, so I think Hoge’s project is an important and exciting movement towards recognizing that we need to look at the totality of the human experience, and not act as if what happens in our mind and in our bodies is completely separate.

(This is a contribution by guest blogger Isabella Mori, a psychotherapist in Vancouver, Canada).