For military personnel with blast-related mild traumatic brain injuries, early symptoms of post-traumatic stress such as anxiety, emotional numbness, flashbacks, and irritability are the strongest predictors of later disability, said researchers from Washington University School of Medicine in St. Louis.

Investigators were surprised that mental health issues more closely correlated with disability than cognitive and physical assessments typically made after concussions such as tests of memory, thinking, balance, coordination, and severity of headaches and dizziness.

“Symptoms of post-traumatic stress and depression have always been thought to develop months to years later,” said David L. Brody, MD, PhD, associate professor of neurology.

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