Identification of pseudobulbar affect symptoms in Veterans with possible traumatic brain injury
Pseudobulbar affect (PBA), a neurological syndrome characterized primarily by involuntary episodes of laughing and crying, can develop secondary to neurological conditions including traumatic brain injury (TBI). Veterans of the wars in Afghanistan and Iraq have an unprecedented risk for TBI, primari...
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| Veröffentlicht in: | Journal of rehabilitation research and development 2015-01, Vol.52 (7), p.839-850 |
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| container_title | Journal of rehabilitation research and development |
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| creator | Fonda, Jennifer R Hunt, Phillip R McGlinchey, Regina E Rudolph, James L Milberg, William P Reynolds, Matthew W Yonan, Charles |
| description | Pseudobulbar affect (PBA), a neurological syndrome characterized primarily by involuntary episodes of laughing and crying, can develop secondary to neurological conditions including traumatic brain injury (TBI). Veterans of the wars in Afghanistan and Iraq have an unprecedented risk for TBI, primarily from blast-related munitions. In this cross-sectional study with linkage to Department of Veterans Affairs (VA) clinical data, Veterans screening positive for TBI on the VA TBI screen (N = 4,282) were mailed packets containing two PBA symptom assessments: a single PBA symptom screen question and the Center for Neurologic Study-Lability Scale (CNS-LS) questionnaire. Seventy percent (n = 513) of the 728 Veteran respondents screened positive for PBA symptoms with a CNS-LS score of 13 or greater. There was strong concordance between PBA symptom prevalence measured with the single screening question and CNS-LS, with high sensitivity (0.87) and positive predictive value (0.93), and moderate specificity (0.79). Posttraumatic stress disorder (54% vs 32%), major depression (35% vs 22%), and anxiety disorder (20% vs 13%) were more common for Veterans with PBA symptoms than for those without. PBA symptoms were common in this Veteran cohort, were detected using simple screening tools, and often co-occurred with other psychiatric disorders common in Veterans. |
| doi_str_mv | 10.1682/JRRD.2014.08.0191 |
| format | Article |
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Veterans of the wars in Afghanistan and Iraq have an unprecedented risk for TBI, primarily from blast-related munitions. In this cross-sectional study with linkage to Department of Veterans Affairs (VA) clinical data, Veterans screening positive for TBI on the VA TBI screen (N = 4,282) were mailed packets containing two PBA symptom assessments: a single PBA symptom screen question and the Center for Neurologic Study-Lability Scale (CNS-LS) questionnaire. Seventy percent (n = 513) of the 728 Veteran respondents screened positive for PBA symptoms with a CNS-LS score of 13 or greater. There was strong concordance between PBA symptom prevalence measured with the single screening question and CNS-LS, with high sensitivity (0.87) and positive predictive value (0.93), and moderate specificity (0.79). Posttraumatic stress disorder (54% vs 32%), major depression (35% vs 22%), and anxiety disorder (20% vs 13%) were more common for Veterans with PBA symptoms than for those without. PBA symptoms were common in this Veteran cohort, were detected using simple screening tools, and often co-occurred with other psychiatric disorders common in Veterans.</description><identifier>ISSN: 0748-7711</identifier><identifier>EISSN: 1938-1352</identifier><identifier>DOI: 10.1682/JRRD.2014.08.0191</identifier><identifier>PMID: 26744849</identifier><identifier>CODEN: JRRDDB</identifier><language>eng</language><publisher>United States: Department of Veterans Affairs</publisher><subject>Brain injuries ; Brain Injuries - complications ; Brain Injuries - diagnosis ; Brain Injuries - epidemiology ; Brain research ; Care and treatment ; Cross-Sectional Studies ; Depressive Disorder, Major - diagnosis ; Depressive Disorder, Major - epidemiology ; Depressive Disorder, Major - etiology ; Disease ; Female ; Humans ; Laboratories ; Male ; Patients ; Pharmaceuticals ; Pharmacy ; Population ; Post-traumatic stress disorder ; Prevalence ; Questionnaires ; R&D ; Research & development ; Retrospective Studies ; Review boards ; Studies ; Traumatic brain injury ; United States - epidemiology ; Veterans ; Veterans - psychology</subject><ispartof>Journal of rehabilitation research and development, 2015-01, Vol.52 (7), p.839-850</ispartof><rights>COPYRIGHT 2015 Department of Veterans Affairs</rights><rights>Copyright Superintendent of Documents 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-68f5f2a09d60162b7f7b64d19d566bca16b5520eaf520f0debbe9fa89c6462a13</citedby><cites>FETCH-LOGICAL-c505t-68f5f2a09d60162b7f7b64d19d566bca16b5520eaf520f0debbe9fa89c6462a13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26744849$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fonda, Jennifer R</creatorcontrib><creatorcontrib>Hunt, Phillip R</creatorcontrib><creatorcontrib>McGlinchey, Regina E</creatorcontrib><creatorcontrib>Rudolph, James L</creatorcontrib><creatorcontrib>Milberg, William P</creatorcontrib><creatorcontrib>Reynolds, Matthew W</creatorcontrib><creatorcontrib>Yonan, Charles</creatorcontrib><title>Identification of pseudobulbar affect symptoms in Veterans with possible traumatic brain injury</title><title>Journal of rehabilitation research and development</title><addtitle>J Rehabil Res Dev</addtitle><description>Pseudobulbar affect (PBA), a neurological syndrome characterized primarily by involuntary episodes of laughing and crying, can develop secondary to neurological conditions including traumatic brain injury (TBI). Veterans of the wars in Afghanistan and Iraq have an unprecedented risk for TBI, primarily from blast-related munitions. In this cross-sectional study with linkage to Department of Veterans Affairs (VA) clinical data, Veterans screening positive for TBI on the VA TBI screen (N = 4,282) were mailed packets containing two PBA symptom assessments: a single PBA symptom screen question and the Center for Neurologic Study-Lability Scale (CNS-LS) questionnaire. Seventy percent (n = 513) of the 728 Veteran respondents screened positive for PBA symptoms with a CNS-LS score of 13 or greater. There was strong concordance between PBA symptom prevalence measured with the single screening question and CNS-LS, with high sensitivity (0.87) and positive predictive value (0.93), and moderate specificity (0.79). Posttraumatic stress disorder (54% vs 32%), major depression (35% vs 22%), and anxiety disorder (20% vs 13%) were more common for Veterans with PBA symptoms than for those without. PBA symptoms were common in this Veteran cohort, were detected using simple screening tools, and often co-occurred with other psychiatric disorders common in Veterans.</description><subject>Brain injuries</subject><subject>Brain Injuries - complications</subject><subject>Brain Injuries - diagnosis</subject><subject>Brain Injuries - epidemiology</subject><subject>Brain research</subject><subject>Care and treatment</subject><subject>Cross-Sectional Studies</subject><subject>Depressive Disorder, Major - diagnosis</subject><subject>Depressive Disorder, Major - epidemiology</subject><subject>Depressive Disorder, Major - etiology</subject><subject>Disease</subject><subject>Female</subject><subject>Humans</subject><subject>Laboratories</subject><subject>Male</subject><subject>Patients</subject><subject>Pharmaceuticals</subject><subject>Pharmacy</subject><subject>Population</subject><subject>Post-traumatic stress disorder</subject><subject>Prevalence</subject><subject>Questionnaires</subject><subject>R&D</subject><subject>Research & development</subject><subject>Retrospective Studies</subject><subject>Review boards</subject><subject>Studies</subject><subject>Traumatic brain injury</subject><subject>United States - 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Academic</collection><jtitle>Journal of rehabilitation research and development</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fonda, Jennifer R</au><au>Hunt, Phillip R</au><au>McGlinchey, Regina E</au><au>Rudolph, James L</au><au>Milberg, William P</au><au>Reynolds, Matthew W</au><au>Yonan, Charles</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Identification of pseudobulbar affect symptoms in Veterans with possible traumatic brain injury</atitle><jtitle>Journal of rehabilitation research and development</jtitle><addtitle>J Rehabil Res Dev</addtitle><date>2015-01-01</date><risdate>2015</risdate><volume>52</volume><issue>7</issue><spage>839</spage><epage>850</epage><pages>839-850</pages><issn>0748-7711</issn><eissn>1938-1352</eissn><coden>JRRDDB</coden><abstract>Pseudobulbar affect (PBA), a neurological syndrome characterized primarily by involuntary episodes of laughing and crying, can develop secondary to neurological conditions including traumatic brain injury (TBI). Veterans of the wars in Afghanistan and Iraq have an unprecedented risk for TBI, primarily from blast-related munitions. In this cross-sectional study with linkage to Department of Veterans Affairs (VA) clinical data, Veterans screening positive for TBI on the VA TBI screen (N = 4,282) were mailed packets containing two PBA symptom assessments: a single PBA symptom screen question and the Center for Neurologic Study-Lability Scale (CNS-LS) questionnaire. Seventy percent (n = 513) of the 728 Veteran respondents screened positive for PBA symptoms with a CNS-LS score of 13 or greater. There was strong concordance between PBA symptom prevalence measured with the single screening question and CNS-LS, with high sensitivity (0.87) and positive predictive value (0.93), and moderate specificity (0.79). Posttraumatic stress disorder (54% vs 32%), major depression (35% vs 22%), and anxiety disorder (20% vs 13%) were more common for Veterans with PBA symptoms than for those without. PBA symptoms were common in this Veteran cohort, were detected using simple screening tools, and often co-occurred with other psychiatric disorders common in Veterans.</abstract><cop>United States</cop><pub>Department of Veterans Affairs</pub><pmid>26744849</pmid><doi>10.1682/JRRD.2014.08.0191</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Brain injuries Brain Injuries - complications Brain Injuries - diagnosis Brain Injuries - epidemiology Brain research Care and treatment Cross-Sectional Studies Depressive Disorder, Major - diagnosis Depressive Disorder, Major - epidemiology Depressive Disorder, Major - etiology Disease Female Humans Laboratories Male Patients Pharmaceuticals Pharmacy Population Post-traumatic stress disorder Prevalence Questionnaires R&D Research & development Retrospective Studies Review boards Studies Traumatic brain injury United States - epidemiology Veterans Veterans - psychology |
| title | Identification of pseudobulbar affect symptoms in Veterans with possible traumatic brain injury |
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