Correlates of Persistent Post-Concussive Symptoms: Results From a Nationally Representative Cohort of Canadian Armed Forces Personnel

INTRODUCTION: Traumatic brain injuries are a significant concern across military populations and consequences can be long-lasting and associated with complex physical and psychological symptoms and comorbidities. For this study, our aim was to understand the prevalence and correlates of persistent post-concussive symptoms (PPCS) among active duty members and Veterans in the Canadian Armed Forces. MATERIALS AND METHODS: The sample (n = 2,941) was from the 2018 Canadian Armed Forces and Veterans Mental Health Survey, a 16-year follow-up study of members who served in the Regular Force and were originally surveyed in the 2002 Canadian Community Health Survey-Canadian Forces Supplement. Correlates of PPCS were analyzed with unadjusted and adjusted logistic regression models. RESULTS: Persistent post-concussive symptoms were associated with lower rank, having released from service, land uniformed environment, younger age, and shorter length of service. Individuals with PPCS were significantly more likely to have co-occurring mental disorders, chronic pain conditions, less adaptive coping styles, sleep difficulties, lower self-rated health, lower life satisfaction, and a reduced feeling of community belonging. CONCLUSIONS: Findings identified individuals with the highest odds of experiencing PPCS. Those with PPCS, compared to those without, had a higher prevalence of co-occurring symptoms and conditions, including mental disorders, chronic pain conditions, and poor psychosocial functioning. Implications include the need for interdisciplinary care to diagnose and manage complex symptoms and comorbidities, and attention to intervention and prevention efforts, involving psychoeducation, to target modifiable psychosocial factors.