WASHINGTON—Following a mild traumatic brain injury or concussion, female veterans report more neurobehavioral symptoms, use more outpatient services and are more often diagnosed with depression than their male counterparts, according to a recent VA study.1 But why?
“TBI effects everyone a little differently,” said the study’s lead author, Alison Cogan, PhD, of the Washington, DC, VAMC. “How much these symptoms may be troublesome and interfere with daily lives, we don’t know.”
Differences between men and women in response and outcomes following TBI is a matter of growing importance in the VA and DoD as the proportion of female servicemembers and veterans continues to grow. Between 2005 and 2015, the number of women who use the VA for their healthcare increased by 46%, the authors noted. By 2030, women are expected to comprise 15% of all veterans.
“It’s a VA priority to provide the best possible care to female as well as male veterans. It’s a natural area of interest to learn how to better serve women veterans who have had TBI over the long run,” Cogan told U.S. Medicine.
The results of the studies in military and veteran populations echoed findings among civilians that women who have had a TBI are diagnosed more often with depression than men who have one. “We’re not sure why there’s a differential,” Cogan said. “It could be the experience of neurobehavioral symptoms; it could be what people experience as problematic or it could be differences in what women share and report versus men.”
The difference in reporting and diagnosis of mental health issues between men and women is common. “In general, women are more likely to seek out mental health services and engage in mental health care,” noted co-author Joel Scholten, MD, VA national director of physical medicine and rehabilitation.
That makes interpreting the study findings more challenging. “While female vets report these symptoms more, we can’t say for sure what’s happening and whether the experience is actually different,” for women than for men, Cogan said.
The study reviewed 55 studies of military servicemembers and veterans who had experienced TBI and included 29 studies in the analysis. In the base studies, TBI was identified by self-report, medical record documentation, screening and other evaluation procedures.
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