Comorbidity of 9/11‐Related PTSD and Depression in the World Trade Center Health Registry 10–11 Years Postdisaster

Abstract

Many studies report elevated prevalence of posttraumatic stress disorder (PTSD) and depression among persons exposed to the September 11, 2001 (9/11) disaster compared to those unexposed; few have evaluated long-term PTSD with comorbid depression. We examined prevalence and risk factors for probable PTSD, probable depression, and both conditions 10-11 years post-9/11 among 29,486 World Trade Center Health Registry enrollees who completed surveys at Wave 1 (2003-2004), Wave 2 (2006-2007), and Wave 3 (2011-2012). Enrollees reporting physician diagnosed pre-9/11 PTSD or depression were excluded. PTSD was defined as scoring ≥ 44 on the PTSD Checklist and depression as scoring ≥ 10 on the 8-item Patient Health Questionnaire. We examined 4 groups: comorbid PTSD and depression, PTSD only, depression only, and neither. Among enrollees, 15.2% reported symptoms indicative of PTSD at Wave 3, 14.9% of depression, and 10.1% of both. Comorbid PTSD and depression was associated with high 9/11 exposures, low social integration, health-related unemployment, and experiencing ≥ 1 traumatic life event post-9/11. Comorbid persons experienced poorer outcomes on all PTSD-related impairment measures, life satisfaction, overall health, and unmet mental health care need compared to those with only a single condition. These findings highlight the importance of ongoing screening and treatment for both conditions, particularly among those at risk for mental health comorbidity.

Police officers who responded to 9/11: Comorbidity of PTSD, depression, and anxiety 10–11 years later

“…Previous studies [Shalev et al, 1998;O'Donnell et al, 2004;Caramanica et al, 2014] report that PTSD with comorbid depression was more frequent than PTSD alone. However, these studies did not examine comorbid anxiety.…”

“…Previous research has shown that psychiatric comorbidity is the rule rather than the exception for people with PTSD, and the presence of psychiatric comorbidity heightens the burden of mental illness, lowers psychosocial functioning, and is more likely to be chronic [Kessler et al, 2005;Wilk et al, 2006;Caramanica et al, 2014;Hruska et al, 2014]. Approximately, 75% of individuals with PTSD experience one or more comorbid disorders [Kaufman and Charney, 2000] and are 80% more likely than those without PTSD to develop another mental disorder [APA, 2013].…”

“…Approximately, 75% of individuals with PTSD experience one or more comorbid disorders [Kaufman and Charney, 2000] and are 80% more likely than those without PTSD to develop another mental disorder [APA, 2013]. There have been several reports on the prevalence or cumulative incidence of comorbid mental health conditions among first responders to the 9/11 events [Stellman et al, 2008;Wisnivesky et al, 2011;Bowler et al, 2012;Caramanica et al, 2014], but risk factors for having PTSD with comorbid mental health conditions of depression and anxiety specifically among police responders have not been well studied.…”

“…Many previous studies of PTSD have focused only on depression as a comorbid disorder [O'Donnell et al, 2004;Caramanica et al, 2014;Contractor et al, 2015]. Among the general population, the highest rates of comorbidity are for the DSM-IV diagnoses of PTSD, depression, and anxiety [Kaufman and Charney, 2000;Brown et al, 2001].…”

Факторы Риска И Ресурсы Устойчивости К Переживанию Террористической Угрозы

“…Понимание клинико-психологических последствий переживания террористической угрозы необходимо для разработки эффективных стратегий снижения негативных исходов воздействия угрозы терроризма на психику человека, среди которых наиболее часто выделяют стрессовые реакции, депрессию, расстройства сна, увеличение потребления психоактивных веществ. Результаты лонгитюдных исследований по-следствий терактов показывают, что интенсивность посттравматических симптомов, вызванных информацией о терактах, постепенно снижается для большей части социума и сохраняется у особой, уязвимой части общества [1]. В этих исследованиях продемонстрирована способность людей сохранять и поддерживать оптимальный уровень функционирования в экстремальных условиях, восстанавливаться после психотравмирующих событий.…”