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Misdiagnosis of post-traumatic stress disorder following severe traumatic brain injury

Community Treatment Centre for Acquired Brain Injury, Glasgow

Tom M. Mcmillan, MAppSci PhD, FBPsS

Faculty of Medicine, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK

Correspondence: Professor T. M. McMillan, Psychological Medicine, Faculty of Medicine, University of Glasgow, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, UK. E-mail: t.m.mcmillan{at}clinmed.gla.ac.uk

Declaration of Interest None.

Background The incidence of post-traumatic stress disorder (PTSD) after traumatic brain injury is unclear. One issue involves the validity of diagnosis using self-report questionnaires.

Aims To compare PTSD‘caseness’ arising from questionnaire self-report and structured interview.

Method Participants (n=34) with traumatic brain injury were recruited. Screening measures and self-report questionnaires were administered, followed by the structured interview.

Results Using questionnaires, 59% fulfilled criteria for PTSD on the Post-traumatic Diagnostic Scale and 44% on the Impact of Events Scale, whereas using structured interview (Clinician-Administered PTSD Scale) only 3% were ‘cases’.This discrepancy may arise from confusions between effects of PTSD and traumatic brain injury.

Conclusions After traumatic brain injury, PTSD self-report measures might be used for screening but not diagnosis.

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