Patterns of comorbidity associated with ICD-11 PTSD among older adults in the United States

Fox, Robert; Hyland, Philip; Power, Joanna McHugh; Coogan, Andrew N.

doi:10.1016/j.psychres.2020.113171

Cited by 18 publications

(42 citation statements)

References 66 publications

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“…Epidemiological research suggests that both lifetime and current traumatic-stress related disorders tend to decline with age (Gum et al, 2009;Kessler et al, 2005;Reynolds et al, 2016). However, recent research using a large, nationally representative sample of older adults from the United States indicates that a meaningful proportion of older adults are affected by ICD-11 PTSD symptoms (Fox et al, 2020a(Fox et al, , 2020b, with 6.1% of adults aged 60 years and older meeting the lifetime symptom requirements of ICD-11 PTSD. As the global proportion of adults aged 60 years or older is expected to nearly double from 12% to 22% between the years 2015 and 2050 (World Health Organization, 2017), it is important to examine variables that may be associated with PTSD and CPTSD in later life.…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic stress disorder, complex PTSD and subtypes of loneliness among older adults

et al. 2021

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Objectives: Research examining the relationship between loneliness and Complex Posttraumatic Stress Disorder (CPTSD) is scarce, particularly among older adults. CPTSD includes the core symptoms of PTSD along with additional symptoms reflecting "disturbances in self-organisation" (DSO). This study examined the cross-sectional relationships between loneliness (emotional and social loneliness) and CPTSD symptoms (i.e., PTSD and DSO symptoms) in older adults. Methods: Structural equation modelling was used to examine these relationships in a nationally representative sample of US adults aged 60-70 years (n = 456). Results: Controlling for covariates, emotional loneliness was associated with PTSD (β = 0.31) and DSO (β = 0.57) symptoms whereas social loneliness was only associated with DSO symptoms (β = 0.25). The model explained 35.0% of the variance in PTSD symptoms and 71.3% in DSO symptoms. Conclusion: These findings have important implications for treating and understanding PTSD/CPTSD and their correlates among older adults.

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Section: Introductionmentioning

confidence: 99%

Posttraumatic stress disorder, complex PTSD and subtypes of loneliness among older adults

et al. 2021

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“…This is of particular importance given our findings that PTSD and CPTSD are associated with a higher burden of symptoms compared with those without these disorders, and indicators from previous research that those with comorbid PTSD/CPTSD are likely to exhibit greater impairment, poorer prognosis, and increased use of general medical and mental health services. 6,9,12,[19][20][21]23,35 Given the evidence that CPTSD is the predominant disorder within clinical samples, there is a particular need to look out for DSO symptoms. The ITQ is a validated self-report measure that can be used to identify probable ICD-11 PTSD/CPTSD and determine those in need of intervention.…”

Section: Discussionmentioning

confidence: 99%

“…22 Looking at patterns of ICD-11 PTSD comorbidity among a nationally representative sample of 530 older adults in the United States, nearly 80% of the sample with PTSD reported at least one comorbid disorder, with the highest level of comorbidity with major depressive disorder (MDD) and alcohol use disorder (AUD). 23 Again, this study did not look at CPTSD. In a small sample of 165 Danish psychiatric outpatients, 94% of participants reported having experienced at least one traumatic event, CPTSD was more common than PTSD (PTSD 8%; CPTSD 36%) and had considerable overlap with ICD-10 affective, anxiety, personality, adjustment, and behavioural and emotional disorders.…”

Section: Limitationsmentioning

confidence: 95%

Trauma exposure and co‐occurring ICD‐11 post‐traumatic stress disorder and complex post‐traumatic stress disorder in adults with lived experience of psychiatric disorder

Lewis

Roberts

et al. 2022

Acta Psychiatr Scand

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Objective To establish factors associated with ICD‐11 post‐traumatic stress disorder (PTSD) and complex PTSD (CPTSD) in a large sample of adults with lived experience of psychiatric disorder and examine the psychiatric burden associated with the two disorders. Methods One thousand three hundred and five adults were recruited from the National Centre for Mental Health (NCMH) cohort. ICD‐11 PTSD/CPTSD were assessed with the International Trauma Questionnaire (ITQ). Binary logistic regression was used to determine factors associated with both PTSD and CPTSD. One‐way between‐groups analysis of variance was conducted to examine the burden associated with the two disorders in terms of symptoms of anxiety, depression, and psychological wellbeing. For post‐hoc pairwise comparisons, the Tukey HSD test was used, and the magnitude of between‐group differences assessed using Cohen's d. Results Probable ICD‐11 CPTSD was more common than PTSD within the sample (PTSD 2.68%; CPTSD 12.72%). We found evidence that PTSD was associated with interpersonal trauma and household income under £20,000 a year. CPTSD was also associated with interpersonal trauma, higher rates of personality disorder, and lower rates of bipolar disorder. Those with probable‐CPTSD had higher levels of current anxiety and depressive symptoms and lower psychological wellbeing in comparison to those with probable‐PTSD and those with neither disorder. Conclusions CPTSD was more prevalent than PTSD in our sample of people with lived experience of psychiatric disorder. Our findings indicate a need for routine screening for trauma histories and PTSD/CPTSD in clinical settings and a greater focus on the need for interventions to treat CPTSD.

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“…Depression is one of the most common comorbid conditions of PTSD ( Horesh et al, 2017 ), and may appear in 50% of those diagnosed with PTSD ( Radell et al, 2020 ). Thus, although PTSD prevalence among older adults is lower compared to other age groups, comorbidity with depression remains high for older adults with PTSD ( Fox et al, 2020 ; Shrira and Hoffman, 2021 ). When such depression stems from trauma exposure and co-occurs with PTSD it constitutes an even heavier burden and leads to more mental distress than either PTSD alone or depression alone ( Flory and Yehuda, 2015 ; Radell et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

The effect of pre-pandemic PTSD and depression symptoms on mental distress among older adults during COVID-19

Cohn‐Schwartz

Shrira

2022

Journal of Psychiatric Research

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Patterns of comorbidity associated with ICD-11 PTSD among older adults in the United States

Cited by 18 publications

References 66 publications

Posttraumatic stress disorder, complex PTSD and subtypes of loneliness among older adults

Posttraumatic stress disorder, complex PTSD and subtypes of loneliness among older adults

Trauma exposure and co‐occurring ICD‐11 post‐traumatic stress disorder and complex post‐traumatic stress disorder in adults with lived experience of psychiatric disorder

The effect of pre-pandemic PTSD and depression symptoms on mental distress among older adults during COVID-19

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