Emerging Patterns of Mental Health Comorbidities Among Those With Blast or Blunt Mechanism TBI: Leveraging Total Brain Diagnostics Data

OBJECTIVE: Traumatic brain injury (TBI) is associated with postinjury mental health (MH) sequelae, yet associations between injury-related risk factors (eg, injury mechanism, multiple injuries) and outcomes remain poorly understood. We leveraged a newly harmonized national dataset to evaluate relationships between TBI characteristics and MH outcomes. DATA SOURCES: We analyzed data from the Total Brain Diagnostics (TBD) dataset, a harmonized data source including 2 large, multisite, longitudinal prospective cohort studies: the Long-term Impact of Military-relevant Brain Injury Consortium's (LIMBIC) and the Translational Research Center for TBI and Stress Disorders (TRACTS). PARTICIPANTS: Veterans and Service Members (n = 3771). DESIGN: Pooled cross-sectional analyses of harmonized data. MAIN MEASURES: TBI Characteristics (Predictors): Number of TBIs, whether the participant had experienced a blast-related TBI, and whether the participant had experienced loss of consciousness secondary to a TBI. Mental Health Conditions/Symptoms (Outcomes): Probable post-traumatic stress disorder (PTSD), probable depression, probable anxiety, suicidal ideation, suicide attempts, and probable unhealthy alcohol use. RESULTS: Blast TBI was associated with greater odds of probable PTSD (OR 1.85, P < .001, 95% CI: 1.57-2.17), probable depression (OR 1.66, P < .001, 95% CI: 1.42-1.95), and probable anxiety (OR 1.73, P < .001, 95% CI: 1.45-2.05) compared with blunt TBI. Post-hoc analyses suggested differences in the frequency of co-occurring MH outcomes among those with blast versus blunt TBIs. CONCLUSIONS: Findings suggest unique MH outcomes driven by blast injury mechanism, highlighting potential differences in underlying etiology.