Differential Diagnosis and Treatment of Comorbid PTSD and TBI in Combat Veterans

Abstract

The purpose of this paper was to summarize what is currently known about diagnosing and treating comorbid PTSD and TBI in combat veterans, beginning with a focus on differential diagnosis of the two disorders in order to elucidate any obfuscation by overlaps in symptomology, and concluding with possible treatment plans, as informed by the diagnostic process. Differential diagnosis was evaluated via self-reported and clinician-administered questionnaires, oculomotor testing, and neuroimaging, while the discussion of treatment options acknowledged the necessity of adjustments to traditional treatment paradigms when a comorbid diagnosis is involved. Self-reporting diagnostic tools are quick and easy to screen for PTSD and TBI, but these methods may over-report PTSD, and under-report TBI. Clinician-administered questionnaires are longer and require a trained professional, but accuracy is gained. The oculomotor testing and SPECT scanning hold promise if the experiments can be repeated with larger sample sizes by additional researchers, but they do appease a more impartial evidence-based approach. Psychotherapy is generally the number one recommended treatment for PTSD and TBI, due to its efficacy compared to pharmaceuticals, and further studies elucidating the efficacy of varieties of psychotherapy treatment may benefit individuals with this comorbid diagnosis.