ADVERTISEMENT

Attention-Deficit/Hyperactivity Disorder in a VA Polytrauma Clinic

A large-scale study suggests that veterans with attention-deficit/hyperactivity disorder may benefit from structured treatment interventions focused on developing compensatory skills for their attention and impulsivity issues.
Federal Practitioner. 2015 February;32(2):14-20
February 17, 2015|Federal Practitioner
Judith B. Kosasih, MD;Thomas A. Hammeke, PhD;Peter Graskamp, PhD;Kelly Owsiany, MS, SPC
Author and Disclosure Information

Dr. Kosasih is a board-certified physiatrist and section chief of the Department of Physical Medicine and Rehabilitation, medical director of the Comprehensive Integrated Inpatient Rehabilitation Program, and medical director of the Polytrauma Clinic Support Team and Amputation Clinic Team; Dr. Hammeke is a board-certified neuropsychologist; Dr. Graskamp is a staff psychologist; and Ms. Owsiany was a psychology technician for the Polytrauma Clinic Support Team at the time of the study; all at the Clement J. Zablocki VAMC in Milwaukee, Wisconsin. Dr. Kosasih also is a professor in the Department of Physical Medicine and Rehabilitation and Dr. Hammeke also is a professor in the Department of Psychiatry and Behavioral Medicine, both at the Medical College of Wisconsin in Milwaukee.

To better understand the treatment needs of young veterans returning home from the wars in Iraq and Afghanistan, this study sought to identify the prevalence rate of ADHD, a condition known to complicate community adjustment. In this study, there was a 10.6% prevalence of ADHD among the 690 OEF/OIF/OND combat veterans seen over the 5-year period in the CJZVAMC PC, which is substantially higher than prevalence estimates in the U.S. general population but similar to estimates in previous military samples.

Compared with veterans who did not have ADHD, veterans with ADHD were younger, less well educated, and reported more problems with attention and concentration but did not have a greater incidence of military TBI or mental health comorbidities. The high prevalence of ADHD in this group argues for greater awareness of this clinical variable and development of intervention programs tailored to the specific skill deficiencies found in the condition, which can be included as part of the comprehensive treatment interventions.

Veterans with ADHD treated in the PC seem to benefit from structured treatment plans and education to promote self-awareness and veteran-centered self-management for effective symptom reduction and coping strategies. Development of effective integrated treatment options with a focus on educational and vocational resources and assistance could facilitate successful community reintegration. Future studies are needed to further assess outcomes of community reintegration, including academic and occupational outcomes, in this population.

Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.

Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.

ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT