The Role of Craniocerebral Trauma in the Dynamics of Combat-Related Post-Traumatic Stress Disorder

Abstract

Study aim. To address the question of the dynamics of the clinical signs of post-traumatic stress disorder (PTSD) and the strength of their relationship with organic changes in the brain. Materials and methods. A longitudinal observations study of 87 combat veterans during the Karabakh war of 1992–1994 was performed in 2009–2011. Two groups of patients were identified. Group 1 consisted of 45 veterans who had sustained mild combat-related craniocerebral trauma followed by the development of PTSD; group 2 consisted of 42 veterans with organic brain damage of traumatic origin. Full general somatic and neurological investigations of patients were undertaken, along with assessment of the patients’ status using a set of psychometric and other scales (including scales for assessment of post-traumatic reactions – the Clinician-Administered PTSD Scale (CAPS) and the Mississippi Scale for Combat-Related PTSD). Results and conclusions. Analysis of patients’ status during the study and comparison with data relating to the time at which trauma was sustained showed that the groups of patients with PTSD were characterized, despite some reduction in post-traumatic symptomatology, by a higher level of severity of all PTSD symptoms during the whole of the 15–18 years of disease development, with simultaneous increases in organic mental changes. In patients with organic brain lesions, the corresponding symptomatology was more severe immediately after the traumatic event than at the time of the study.