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

Abstract

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.