Traumatic Brain Injury and Psychiatric Co-Morbidity in the United States

  • Michael G. VaughnEmail author
  • Christopher P. Salas-Wright
  • Rachel John
  • Katherine J. Holzer
  • Zhengmin Qian
  • Christopher Veeh
Original Paper


The objective of the present study was to provide a nationally representative psychiatric epidemiologic investigation of traumatic brain injury (TBI) and its co-morbid conditions. Data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC-III) collected between 2012 and 2013 was used. Results indicated that TBI was significantly associated with any lifetime mental health (AOR = 2.32, 95% CI = 1.65–3.70), substance use disorder (AOR = 1.57–1.01-2.42), and violent (AOR = 1.65, 95% CI = 1.03–2.65) and nonviolent (AOR = 1.84, 95% CI = 1.25–2.70) criminal behaviors. In our study, TBI was highly comorbid with psychiatric disorders and especially antisocial behaviors, both violent and non-violent.


Traumatic brain injury TBI Violence Substance use Mental health 



This research was supported in part by grant number R25 DA030310 from the National Institute on Drug Abuse at the National Institutes of Health and by the National Center for Advancing Translational Sciences, National Institutes of Health, through BU-CTSI Grant Number 1KL2TR001411. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

Compliance with Ethical Standards

Conflict of Interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. 1.
    Brenner LA, Hostetter TA, Barnes SM, Stearns-Yoder KA, Soberay KA, Forster JE. Traumatic brain injury, psychiatric diagnoses, and suicide risk among veterans seeking services related to homelessness. Brain Inj. 2017;31:1731–5. Scholar
  2. 2.
    Brenner LA, Ignacio RV, Blow FC. Suicide and traumatic brain injury among individuals seeking veterans health administration services. J Head Trauma Rehabil. 2011;26:257–64. Scholar
  3. 3.
    Adams RS, Corrigan JD, Mohr BA, Williams TV, Larson MJ. Traumatic brain injury and post-deployment binge drinking among male and female army active duty service members returning from operation enduring freedom/operation Iraqi freedom. J Neurotrauma. 2017;34:1457–65. Scholar
  4. 4.
    Kennedy E, Cohen M, Munafò M. Childhood traumatic brain injury and the associations with risk behavior in adolescence and young adulthood: a systematic review. J Head Trauma Rehabil. 2017;32:425–32. Scholar
  5. 5.
    Kennedy E, Heron J, Munafó M. Substance use, criminal behaviour and psychiatric symptoms following childhood traumatic brain injury: findings from the ALSPAC cohort. Eur Child Adolesc Psychiatry. 2017;26:1197–206. Scholar
  6. 6.
    Whelan-Goodinson R, Ponsford J, Johnston L, Grant F. Psychiatric disorders following traumatic brain injury: their nature and frequency. J Head Trauma Rehabil. 2009;24:324–32. Scholar
  7. 7.
    Wojtowicz M, Silverberg ND, Bui E, Zafonte R, Simon N, Iverson GL. Psychiatric comorbidity and psychosocial problems among treatment-seeking veterans with a history of mild traumatic brain injury. Focus. 2017;15:384–9. Scholar
  8. 8.
    Bombardier CH, Fann JR, Temkin NR, Esselman PC, Barber J, Dikmen SS. Rates of major depressive disorder and clinical outcomes following traumatic brain injury. JAMA. 2010;303:1938–45. Scholar
  9. 9.
    Hart T, Brenner L, Clark AN, Bogner JA, Novack TA, Chervoneva I, et al. Major and minor depression after traumatic brain injury. Arch Phys Med Rehabil. 2011;92:1211–9. Scholar
  10. 10.
    Hesdorffer DC, Rauch SL, Tamminga CA. Long-term psychiatric outcomes following traumatic brain injury: a review of the literature. J Head Trauma Rehabil. 2009;24:452–9. Scholar
  11. 11.
    Moreno JA, McKerral M. Relationships between risky sexual behaviour, dysexecutive problems, and mental health in the years following interdisciplinary TBI rehabilitation. Neuropsychol Rehabil. 2018;28:34–56. Scholar
  12. 12.
    Riggio S, Wong M. Neurobehavioral sequelae of traumatic brain injury. Mt Sinai J Med. 2009;76:163–72. Scholar
  13. 13.
    Bryant RA, O'Donnell ML, Creamer M, McFarlane AC, Clark CR, Silove D. The psychiatric sequelae of traumatic injury. Am J Psychiatry. 2010;167:312–20. Scholar
  14. 14.
    Scofield DE, Proctor SP, Kardouni JR, Hill OT, McKinnon CJ. Risk factors for mild traumatic brain injury and subsequent post-traumatic stress disorder and mental health disorders among United States army soldiers. J Neurotrauma. 2017;34:3249–55. Scholar
  15. 15.
    Castriotta RJ, Murthy JN. Sleep disorders in patients with traumatic brain injury. CNS Drugs. 2011;25:175–85. Scholar
  16. 16.
    Mathias JL, Alvaro PK. Prevalence of sleep disturbances, disorders, and problems following traumatic brain injury: a meta-analysis. Sleep Med. 2012;13:898–905. Scholar
  17. 17.
    Viola-Saltzman M, Watson NF. Traumatic brain injury and sleep disorders. Neurol Clin. 2012;30:1299–312. Scholar
  18. 18.
    Mosti C, Coccaro EF. Mild traumatic brain injury and aggression, impulsivity, and history of other-and self-directed aggression. J Neuropsychiatry Clin Neurosci. 2018;30:220–7. Scholar
  19. 19.
    Fu TS, Jing R, McFaull SR, Cusimano MD. Health & economic burden of traumatic brain injury in the emergency department. Can J Neurol Sci. 2016;43:238–47. Scholar
  20. 20.
    Gooch CL, Pracht E, Borenstein AR. The burden of neurological disease in the United States: a summary report and call to action. Ann Neurol. 2017;81:479–84. Scholar
  21. 21.
    Humphreys I, Wood RL, Phillips CJ, Macey S. The costs of traumatic brain injury: a literature review. Clinicoecon Outcomes Res. 2013;5:281–7. Scholar
  22. 22.
    Kayani NA, Homan S, Yun S, Zhu BP. Health and economic burden of traumatic brain injury: Missouri, 2001–2005. Public Health Rep. 2009;124:551–60. Scholar
  23. 23.
    Marin JR, Weaver MD, Mannix RC. Burden of USA hospital charges for traumatic brain injury. Brain Inj. 2017;31:24–31. Scholar
  24. 24.
    Silverberg ND, Panenka WJ, Iverson GL. Work productivity loss after mild traumatic brain injury. Arch Phys Med Rehabil. 2018;99:250–6. Scholar
  25. 25.
    McHugo GJ, Krassenbaum S, Donley S, Corrigan JD, Bogner J, Drake RE. The prevalence of traumatic brain injury among people with co-occurring mental health and substance use disorders. J Head Trauma Rehabil. 2017;32:E65–74. Scholar
  26. 26.
    National Institute on Alcohol Abuse and Alcoholism. National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). Accessed 11 July 2018.
  27. 27.
    Grant BF, Goldstein RB, Smith SM, Jung J, Zhang H, Chou SP, et al. The alcohol use disorder and associated disabilities interview Schedule-5 (AUDADIS-5): reliability of substance use and psychiatric disorder modules in a general population sample. Drug Alcohol Depend. 2015;148:27–33. Scholar
  28. 28.
    Vaughn MG, Salas-Wright CP, Maynard BR, Qian Z, Terzis L, Kusow AM, et al. Criminal epidemiology and the immigrant paradox: intergenerational discontinuity in violence and antisocial behavior among immigrants. J Crim Justice. 2014;42:483–90. Scholar
  29. 29.
    Vaughn MG, DeLisi M, Gunter T, Fu Q, Beaver KM, Perron BE, et al. The severe 5%: a latent class analysis of the externalizing behavior spectrum in the United States. J Crim Justice. 2011;39:75–80. Scholar
  30. 30.
    Vaughn MG, DeLisi M, Salas-Wright CP, Maynard BR. Violence and externalizing behavior among youth in the United States: is there a severe 5%? Youth Violence Juvenile Justice. 2014;12:3–21. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Michael G. Vaughn
    • 1
    Email author
  • Christopher P. Salas-Wright
    • 2
  • Rachel John
    • 2
  • Katherine J. Holzer
    • 1
  • Zhengmin Qian
    • 3
  • Christopher Veeh
    • 4
  1. 1.School of Social Work, College for Public Health and Social JusticeSaint Louis UniversitySt. LouisUSA
  2. 2.School of Social WorkBoston UniversityBostonUSA
  3. 3.Department of Epidemiology and Biostatistics, College for Public Health and Social JusticeSaint Louis UniversitySt. LouisUSA
  4. 4.School of Social WorkUniversity of IowaIowa CityUSA

Personalised recommendations