Current and Lifetime Psychiatric Disorders among Veterans with War Zone-Related Posttraumatic Stress Disorder

Abstract

Previous research has found high rates of psychiatric disorders among veterans with war zone-related posttraumatic stress disorder (PTSD). However, many studies in this area are methodologically limited in ways that preclude unambiguous interpretation of their results. The purpose of this study was to address some of these limitations to clarify the relationship between war zone-related PTSD and other disorders. Participants were 311 male Vietnam theater veterans assessed at the National Center for PTSD at the Boston Veterans Affairs Medical Center. The Clinician-Administered PTSD Scale and the Structured Clinical Interview for DSM-III-R were used to derive current and lifetime diagnoses of PTSD, other axis I disorders (mood, anxiety, substance use, psychotic, and somatoform disorders), and two axis II disorders (borderline and antisocial personality disorders only). Participants also completed several self-report measures of PTSD and general psychopathology. Relative to veterans without PTSD, veterans with PTSD had significantly higher rates of current major depression, bipolar disorder, panic disorder, and social phobia, as well as significantly higher rates of lifetime major depression, panic disorder, social phobia, and obsessive-compulsive disorder. In addition, veterans with PTSD scored significantly higher on all self-report measures of PTSD and general psychopathology. These results provide further evidence that PTSD is associated with high rates of additional psychiatric disorders, particularly mood disorders and other anxiety disorders. The implications of these findings and suggestions about the direction of future research in this area are discussed.

Influence of PTSD symptom clusters on smoking status among help-seeking Iraq and Afghanistan veterans

“…Given the comorbidity between PTSD and depression ( Orsillo et al, 1996 ), we examined whether emotional numbing was a proxy risk factor for depression ( Kraemer, Kazdin, Offord, & Kupfer, 2001 ). As described by Kraemer et al (2001) , a proxy risk factor is one which predicts an outcome by virtue of its strong correlation with another variable.…”

A High Risk Twin Study of Combat-Related PTSD Comorbidity

“…PTSD has also been shown to have high lifetime rates of psychiatric comorbidity (Davidson et al, 1991, Helzer et al, 1987Keane & Wolfe, 1990;Kessler et al 1995;Kulka et al, 1990). Due to the high prevalence of PTSD in veteran samples, many studies of PTSD comorbidity have focused on Vietnam Veterans (Centers for Disease Control [CDC], 1987;Davidson et al, 1989;Faustman &White, 1989;Keane & Wolfe, 1990;Kulka et al, 1990;Orsillo et al, 1996;Resnick et al, 1989;Sierles et al, 1983). Although identifying the mechanisms underlying PTSD comorbidity is important for understanding the etiology of and developing treatment for the disorder, these mechanisms remain unclear.…”

The factor structure of psychiatric comorbidity among Iraq/Afghanistan-era veterans and its relationship to violence, incarceration, suicide attempts, and suicidality

“…High rates of psychiatric comorbidity are also common among veterans (Orsillo et al, 1996;Thomas et al, 2010), which is consistent with factor analytic studies demonstrating that common psychiatric disorders load onto three higher-order factors: (1) an externalizing/substance-use disorder (SUD) factor characterized by alcohol and drug disorders, nicotine dependence, and antisocial personality disorder; (2) a distress factor characterized by depression and generalized anxiety disorder; and (3) a fear factor characterized by social phobia, simple phobia, and panic disorder (Krueger, 1999;Eaton et al, 2011).…”