Depression in comorbid obsessive-compulsive disorder and posttraumatic stress disorder

Merrill, Anna; Gershuny, Beth S.; Baer, Lee; Jenike, Michael A.

doi:10.1002/jclp.20783

Cited by 11 publications

(10 citation statements)

References 14 publications

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“…However, the literature detailing a distinct comorbid presentation of OCD and PTSD (De Silva and Marks, 2001; Fontenelle et al, 2012; Fostick et al, 2012; Gershuny et al, 2003; Sasson et al, 2005) supports the consideration of these results in that context. The absence of significant differences in dimensional depression symptoms between the OCD+PTSD and OCD groups at baseline provides contrary evidence to prior work proposing that depression may account for this comorbidity (Huppert et al, 2005; Merrill et al, 2011). Instead, these results suggest that comorbid OCD and PTSD may be a unique presentation warranting empirical attention.…”

Section: Discussioncontrasting

confidence: 99%

“…Mechanisms of co-occurrence between OCD and PTSD remain poorly understood. Some have hypothesized that traumatic events play an etiological role in the development of OCD symptoms for a subgroup of individuals (Fontenelle et al, 2012), while others have argued that depression or other shared symptoms may best account for the overlap between these two disorders (Huppert et al, 2005; Merrill et al, 2011). Regardless of the specific mechanisms of comorbidity, clinical and epidemiological observations suggest that lifetime PTSD may be an important consideration in the research and treatment of OCD.…”

Section: Introductionmentioning

confidence: 99%

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The impact of lifetime PTSD on the seven-year course and clinical characteristics of OCD

Ojserkis

Boisseau

Reddy

et al. 2017

Psychiatry Research

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Research has suggested that the co-occurrence of PTSD in individuals with OCD is associated with more severe symptoms and less responsivity to empirically supported treatment as compared to individuals with OCD and no history of PTSD. However, much of this work has been limited by non-empirical case report design, cross-sectional and retrospective analyses, or small sample sizes. The current study extended this research by comparing the clinical characteristics of individuals with OCD with and without a lifetime PTSD diagnosis in a large, naturalistic, longitudinal sample over the course of seven years. At baseline, individuals with comorbid lifetime PTSD reported significantly more severe symptoms of OCD (including symptom levels and insight), lower quality of life, and higher rates of comorbid lifetime mood and substance use disorders than participants without lifetime PTSD. Further, individuals with comorbid OCD and lifetime PTSD reported significantly more severe OCD symptoms over the course of seven years than those without lifetime PTSD. These results are largely consistent with the existing literature and support the need to consider PTSD symptoms in the assessment and treatment of OCD.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of lifetime PTSD on the seven-year course and clinical characteristics of OCD

Ojserkis

Boisseau

Reddy

et al. 2017

Psychiatry Research

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“…Indeed, recent research has shown that depression mediates the association between OCD and other comorbid disorders (e.g., Merrill, Gershuny, Baer, & Jenike, 2011). Consideration of the temporal precedence of the onset of OCD, depression, and eating disorders also appears to support depression as a potential mediator.…”

Section: Introductionmentioning

confidence: 92%

Depression mediates the relationship between obsessive–compulsive symptoms and eating disorder symptoms in an inpatient sample

Kim

Ebesutani

Wall³

et al. 2012

Journal of Obsessive-Compulsive and Related Disorders

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“…Although not specifically evaluated in perinatal samples, researchers find a unique association between OCD and PTSD (de Silva & Marks, 2001;Huppert et al, 2005;Merrill, Gershuny, Baer, & Jenike, 2011;Nacasch, Fostic, & Zohar, 2011). On a basic level, high rates of comorbidity between the two disorders have been noted.…”

Section: Postpartum Ocd and Ptsdmentioning

confidence: 99%

“…However, there may be more complex reasons for why these disorders are so highly comorbid with one another. Symptom overlap between PTSD and OCD has often been cited as an explanation for the associations demonstrated between these two disorders (Huppert et al, 2005;Merrill et al, 2011). These symptoms include cognitive intrusions as well as avoidance of thoughts, activities or people that may trigger the unwanted intrusions.…”

Section: Postpartum Ocd and Ptsdmentioning

confidence: 99%

Factor structure and risk of perinatal posttraumatic stress disorder

Grekin¹

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Existing research suggests that childbirth may be a significant trigger of posttraumatic stress disorder (PTSD) in the postpartum period. While literature presents important results regarding the prevalence and risk factors of postpartum PTSD, several gaps remain. The current study examined the factor structure of perinatal PTSD by comparing two supported structures of PTSD. Additionally, structural equation modeling (SEM) was used to examine whether subjective birthing experiences and objective childbirth characteristics mediated the relationship between psychosocial variables (history of trauma, fear of childbirth, and social support) and postpartum PTSD. Women were recruited during pregnancy from the University of Iowa Hospitals and Clinics. Symptoms of PTSD, OCD, and depression, as well as risk factors for postpartum PTSD were measured at pregnancy, 4, 8, and 12 weeks postpartum. Additionally, structured clinical interviews were conducted to assess for depression, PTSD, OCD, and mania. Five factor structures were examined using confirmatory factor analysis, including two four factor models with correlated latent factors, two four factor hierarchical models, and a unidimensional model. All models resulted in adequate global fit and excellent component fit. The most parsimonious model, the unidimensional model was retained. The SEM showed that subjective perceptions of childbirth mediated the relationship between fear of childbirth and postpartum PTSD at 4 weeks postpartum. At 8 weeks postpartum, objective childbirth characteristics mediated the relationship between fear of childbirth and postpartum PTSD and there was a direct relationship between fear of childbirth and postpartum PTSD. iii The current study supports a hierarchical or unidimensional structure of PTSD in perinatal samples emphasizing the importance of a higher-order, shared dimension of PTSD symptoms. It further emphasizes the importance of fear of childbirth and both subjective and objective birthing experiences in predicting postpartum psychopathology. Future research should examine these symptoms and risk factors in a more diverse and at-risk sample. Additionally, accurate assessments, and influential interventions for postpartum PTSD should be further examined.

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Depression in comorbid obsessive-compulsive disorder and posttraumatic stress disorder

Cited by 11 publications

References 14 publications

The impact of lifetime PTSD on the seven-year course and clinical characteristics of OCD

The impact of lifetime PTSD on the seven-year course and clinical characteristics of OCD

Depression mediates the relationship between obsessive–compulsive symptoms and eating disorder symptoms in an inpatient sample

Factor structure and risk of perinatal posttraumatic stress disorder

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