Research Reports - The prevalence of traumatic brain injury among people with co-occurring mental health and substance use disorders
J Head Trauma Rehabil. 2016 Jul 21. [Epub ahead of print]
McHugo GJ(1), Krassenbaum S, Donley S, Corrigan JD, Bogner J, Drake RE.
OBJECTIVE: To estimate the rate and severity of traumatic brain injury (TBI)
among people with co-occurring mental health and substance use disorders and to
compare demographic, diagnostic, and institutionalization differences between
those who screen positive or negative.
SETTING: Outpatient community mental health center in Washington, District of
PARTICIPANTS: A total of 295 people with co-occurring mental health and substance
use disorders enrolled in a prospective study of integrated treatment of
DESIGN: Cross-sectional baseline assessment.
MAIN MEASURES: The Ohio State University TBI Identification Method. Standardized
measures assessed psychiatric diagnoses, symptom severity, current and lifetime
substance use, and history of institutionalization.
RESULTS: Eighty percent screened positive for TBI, and 25% reported at least 1
moderate or severe TBI. TBI was associated with current alcohol use and
psychiatric symptom severity and with lifetime institutionalization and
homelessness. It was more common among participants with posttraumatic stress
disorder, borderline personality disorder, and antisocial personality disorder.
Men (vs women) and participants with psychotic disorders (vs those with mood
disorders) had an earlier age of first TBI with loss of consciousness.
CONCLUSION: TBI is common among people with co-occurring mental health and
substance use disorders. Repeated and serious TBIs are common in this population.
Failure to detect TBI in people with co-occurring disorders who are seeking
integrated treatment could lead to misdiagnosis and inappropriately targeted
treatment and rehabilitation.