Post Deployment Assessment & Treatment (PDAT) Inpatient Rehabilitation Program Improves Both Psychological Distress and Physical Pain Experience in Veterans w/ History of mTBI/Polytrauma Comorbidities

Abstract

<h3>Research Objectives</h3> To evaluate the impact of a novel integrated interdisciplinary rehabilitation program on both psychological distress and physical pain (as well as striving to understand their relatedness) in Veterans with mTBI/polytrauma diagnoses and comorbidities including chronic pain after combat deployment. <h3>Design</h3> Before-and-after trial of a novel integrated and holistically-informed rehabilitation program for Veterans with complex polytrauma symptom presentations. <h3>Setting</h3> Interdisciplinary residential PDAT rehabilitation program within a VA hospital. <h3>Participants</h3> Participants were 21 males (mean age = 36, SD = 8.8) participating in the PDAT residential program. Mean number of deployments was 1.8 (SD = 1.0). All participants had history of mTBI. Common mental health comorbidities included trauma/stress-related disorders, mood disorders, sleep disorders, and problems with alcohol misuse. Most participants experienced chronic pain. Additional demographics will be detailed. <h3>Interventions</h3> Participants received intensive individual and group therapies from an integrated team emphasizing behavioral health, PM&R, CAM and other approaches with collective focus on pain, sleep, stress/anger management, mood, cognition, communication, and community reintegration. Inpatient treatment varied from 7 to 38 weeks in extreme cases. <h3>Main Outcome Measures</h3> Beck Depression Inventory-II and PTSD Checklist for DSM-5 are measures of depressive and PTSD symptomatology well-validated with Veterans. The Brief Pain Inventory measures aspects of pain including both severity and disabling impact on daily function. <h3>Results</h3> Results showed significant improvement of depression and PTSD symptoms after program participation (t = 5.38 and 7.32, respectively; both p <.001). Results also showed significantly reduced pain severity ratings (t = 2.47, p=.023), although interestingly, greater reductions were shown for impact of pain on daily function (t= 3.31; p=.003). Covariates and potential moderators will be further detailed. <h3>Conclusions</h3> Demonstrates significant benefit of PDAT inpatient rehabilitation program participation toward improvement of both psychological distress and comorbid physical pain. Findings can inform developing treatment approaches, particularly as expanded non-pharmacological treatment options for chronic pain are needed, and as studies increasingly provide support for integrated treatment of pain, mood/stress disorders, and sleep problems presenting comorbidly with mTBI. <h3>Author(s) Disclosures</h3> Nothing to Disclose.