Veterans with TBI have higher rates of unemployment




WASHINGTON – Soldiers who experience traumatic brain injury (TBI) while deployed have a much higher rate of unemployment than those who experience no TBI during their tour of duty, according to a study presented at the annual meeting of the American Headache Society.

“We know that TBI and PTSD [post-traumatic stress disorder] can lead to headaches, depression, and loss of libido, but there’s very little data on the long-term effects of TBI on [veterans], and therefore very little control data,” explained Dr. James R. Couch of the University of Oklahoma in Oklahoma City.

Dr. Couch and his coinvestigators looked at 5,743 veterans of Operation Iraqi Freedom and Operation Enduring Freedom who had been deployed between June 2008 and April 2011, 1,325 (23%) of whom had experienced TBI while serving. The first 500 subjects seen were then frequency matched with a control subject who did not experience TBI, based on age, sex, race, and deployment length.

From this pool, 67 pairs were finally selected for inclusion, all of whom were 2-11 years post TBI: 39 pairs were 2-7 years post TBI and the remaining 28 pairs were 8-11 years post TBI. All subjects were 25-60 years old. Marital and employment data were collected from each subject, and each subject completed a TBI questionnaire, headache questionnaire, Beck Depression Inventory 2, and post-traumatic stress disorder questionnaire, from which bivariate analyses were performed.

Although marital status was not found to be significantly tied to TBI experience while deployed, unemployment rates were consistently and significantly higher in the TBI cohort, compared with their non-TBI counterparts. In the 2-7 years post-TBI group, 35.9% of subjects were unemployed, while only 10.3% of non-TBI subjects were without a job (P = .014). In the 8-11 years post-TBI cohort, 50.0% of subjects were unemployed, compared with 7.1% of controls who were unemployed. No significant association, however, was found between frequency of headache or severity of TBI with either unemployment or marital status.

The most important thing to take away, said Dr. Couch, is “the marked difference in unemployment from 4-11 years after TBI, and that things seem to be getting worse as time goes along. Headache, depression, PTSD – none of these stand out as singular causes but are all known to be related to [TBI], and severity of TBI was not strongly associated.”

Dr. Couch disclosed receiving consulting fees/honoraria from St. Jude Medical.

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