Taux de comorbidité du traumatisme cranio-cérébral et du trouble de stress post-traumatique chez les civils et les militaires : une méta-analyse

Authors: Loignon, Alexandra
Advisor: Belleville, Geneviève
Abstract: The risk of developing a posttraumatic stress disorder (PTSD) after a traumatic brain injury (TBI) and the factors that may affect the manifestation of both disorders in a same individual remain to be clarified. Military personnel (including veterans who have been active members) are at higher risk of physical injuries and exposure to potentially traumatic events and could be particularly susceptible to display the TBI-PTSD comorbidity. This dissertation aims to depict the frequency of PTSD after TBI, the mechanisms behind the development of this dual diagnosis, its symptomatic particularities and risk factors. A systematic review and meta-analysis were conducted to determine if adults with TBI are at greater risk of developing PTSD than other trauma-exposed populations, and if this risk is even greater in military than in civilian populations. A secondary aim was to determine the factors that increase the probability to experience PTSD after TBI. Results from the 33 studies that were included in this meta-analysis suggest that the risk of developing PTSD is 2.68 times greater (27%) after TBI than when there is no such head injury (11%). Moreover, individuals with TBI are 4.18 times more likely to have a diagnosis of PTSD than those without TBI when they are in the military (37%), compared with 1.26 for civilians (16%). The risk of PTSD after TBI is concurrently attributable to the methods of the included studies (objectives focused on PTSD diagnosis, type of comparison group) and to participants’ characteristics (country, sex, type of traumatic event). TBI diagnosis represents greater risk for PTSD, especially in military and veteran settings. The dual diagnosis of TBI and PTSD complicates the patients’ portrait, the burden of the caregivers and the clinicians’ work. The combination of these disorders requires an interdisciplinary collaboration, as physical and psychological traumas are closely intertwined.
Document Type: Thèse de doctorat
Issue Date: 2019
Open Access Date: 3 December 2019
Permalink: http://hdl.handle.net/20.500.11794/37479
Grantor: Université Laval
Collection:Thèses et mémoires

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