Posttraumatic Stress Disorder and Depression Following Trauma: Understanding Comorbidity

O’Donnell, Meaghan; Creamer, Mark; Pattison, Philippa

doi:10.1176/appi.ajp.161.8.1390

Cited by 625 publications

(475 citation statements)

References 19 publications

Supporting

Mentioning

404

Contrasting

Unclassified

Order By: Relevance

“…Empirical findings have demonstrated a high rate of comorbidity between PTSD and depressive symptoms (O’Donnell, Creamer, & Pattison, 2004; Tekin et al, 2016). Ramsawh et al (2014) found that individuals with both PTSD and depression were 2.6 times more likely to have past-year suicidality than those with either diagnosis alone.…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

Cheng

Liang

et al. 2018

European Journal of Psychotraumatology

View full text Add to dashboard Cite

Background: Many studies have reported the comorbidity of posttraumatic stress disorder (PTSD) and depression in children. However, the underlying relationship between PTSD and depression remains unclear.Objective: This study examines the relationship between PTSD and depressive symptoms in children who survived the Wenchuan earthquake in China.Methods: In total, 301 children were assessed at four months and then followed up at 29, 40 and 52 months after the disaster. The ages of the children ranged from 9.6–14.6 years old, and the sample included 157 males and 144 females. The children were assessed by using the University of California at Los Angeles PTSD reaction index for DSM-IV for PTSD symptoms and the Children’s Depression Inventory for depressive symptoms.Results: Comorbid PTSD and depressive symptoms were prevalent in 4.0, 3.3, 3.7 and 5.1% of the participants at times 1, 2, 3 and 4, respectively. The cross-lagged analysis indicated that PTSD symptoms at time 1 predicted depressive symptoms at time 2; depressive symptoms at time 1 predicted PTSD symptoms at time 2; depressive symptoms at time 2 predicted PTSD symptoms at time 3; and depressive symptoms at time 3 predicted PTSD symptoms at time 4. The findings also showed that being female, poor parental relationships and trauma exposure were risk factors for PTSD or depressive symptoms.Conclusions: The results suggest that the causal relationship between PTSD and depressive symptoms changes over time; the effects of PTSD symptoms tend to decrease, while those of depressive symptoms tend to increase. Two stages of the relationship between PTSD and depressive symptoms were observed, namely, that PTSD and depressive symptoms first influenced each other and then that depressive symptoms predicted PTSD. The results of our study also suggest that females with poor parental relationships and a high degree of trauma exposure are more likely to require intervention.

show abstract

Section: Introductionmentioning

confidence: 99%

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

Cheng

Liang

et al. 2018

European Journal of Psychotraumatology

View full text Add to dashboard Cite

show abstract

“…However, there is a need to address the comorbidity that is often found (O’Donnell, Creamer, & Pattison, 2004), particularly at the PHC level (Campbell et al, 2007; Herman et al, 2009). Subthreshold presentations of PTSD are associated with similar levels of psychosocial impairment to those found in people diagnosed with PTSD (Cukor, Wyka, Jayasinghe, & Difede, 2010; Zlotnick, Franklin, & Zimmerman, 2002).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Verhey

Gibson

Brakarsh

et al. 2018

European Journal of Psychotraumatology

View full text Add to dashboard Cite

Background: We investigated the prevalence of and factors associated with post-traumatic stress disorder (PTSD) and common mental disorders (CMDs), which include depression and anxiety disorders, in a setting with a prevalence of high human immunodeficiency virus (HIV) within a primary care clinic, using the PTSD Checklist for DSM-5 and the 14-item Shona Symptom Questionnaire, both locally validated screening tools.Methods: A cross-sectional survey was carried out with adult patients (n = 204) from the largest primary care clinic facility in Harare, Zimbabwe, in June 2016.Results: A total of 83 patients (40.7%) met the criteria for probable PTSD, of whom 57 (69.5%) had comorbid CMDs. Among people living with HIV, 42 (55.3%) had PTSD. Probable PTSD was associated with having experienced a negative life event in the past 6 months [adjusted odds ratio (OR) 3.73, 95% confidence interval (CI) 1.49–9.34] or screening positive for one or more CMD (adjusted OR 6.48, 95% CI 3.35–2.54).Conclusion: People living with HIV showed a high prevalence of PTSD and CMD comorbidity. PTSD screening should be considered when the CMD screen is positive and there is a history of negative life events.

show abstract

“…Although the focus of this paper was on PTSD, a host of other psychiatric outcomes (i.e. depression, other anxiety disorders, substance abuse) tend to co-occur with PTSD symptomatology following trauma exposure (Brady, Killeen, Brewerton, & Lucerini, 2000;Breslau, Davis, Peterson, & Schultz, 2000;Brown, Fulton, Wilkeson, & Petty, 2000;Creamer, McFarlane, & Burgess, 2005;O'Donnell, Creamer, & Pattison, 2004). Similar to PTSD, depression (Evans, Charney, Lewis, Golden, Gorman, Krishnan et al, 2005), other anxiety disorders (Sareen et al, 2005;Scott, Bruffaerts, Tsang, Ormel, Alonso, Angermeyer et al, 2007), and substance-related disorders (Dickey, Normand, Weiss, Drake, & Azeni, 2002) have been independently associated with chronic medical conditions.…”

Section: Discussionmentioning

confidence: 99%

Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey-Replication (NCS-R)

2008

View full text Add to dashboard Cite

The present study sought to extend prior research by using data from the National Comorbidity Survey Replication (NCS-R) to examine the relationship between number of lifetime traumas, PTSD and fifteen self-reported chronic medical conditions. The goal was to determine whether the commonly found relationship between PTSD symptomatology and physical health were better explained by the number of lifetime traumas experienced. The NCS-R is a representative U.S. household survey that assessed lifetime experience of a variety of traumas, lifetime diagnosis of PTSD and fifteen chronic medical conditions (e.g. pain conditions, cardiovascular disorders, etc.). Two major findings emerged: 1) there was a graded relationship between trauma exposure, PTSD, and the majority of chronic medical conditions where individuals with PTSD had the highest likelihood of chronic medical condition and non-traumatized individuals had the lowest risk and; 2) with the exception of headaches, the relationship between PTSD and chronic medical conditions was explained by the number of lifetime traumas experienced when analyses were subset to traumatized individuals. The present study supports prior research suggesting that multiple traumas have a cumulative effect on physical health. The impact of trauma on health may be independent of PTSD symptomatology. Keywords trauma; PTSD; chronic medical conditions; National Comorbidity Survey-Replication Posttraumatic stress disorder (PTSD) affects 6.8% to 7.8% of the U.S. population during their lifetime (Cox, 2002;Kessler, Berglund, Demler, Jin, & Walters, 2005) and is recognized as an expensive form of psychiatric disability (Marciniak, Lage, Dunayevich, Russell, Bowman, Landbloom et al., 2005;Walker, Katon, Russo, Ciechanowski, Newman, & Wagner, 2003). According to one estimate, the annual cost of anxiety disorders in the U.S. was approximately $42.3 billion in mental and physical health services, with PTSD ranking as the highest in terms of per person health care expenditures (Greenberg, Sisitsky, Kessler, Finkelstein, Berndt, Davidson et al., 1999). Further, the majority of the economic burden (54%) is due to direct nonpsychiatric health care costs such as primary care and emergency room visits (Greenberg et al., 1999). Numerous studies have shown a consistent association between PTSD and both self-reported measures of physical health such as chronic pain, back problems and general physical complaints (Asmundson, Coons, Taylor, & Katz, 2002;Beckham, Crawford, Feldman, Kirby, Hertzberg, Davidson et al., 1997;McWilliams, Cox, & Enns, 2003; RoyByrne, Smith, Goldberg, Afari, & Buchwald, 2004 Goldberg, 2006;Vedantham, Brunet, Boyer, Weiss, Metzler, & Marmar, 2001;Wagner, Wolfe, Rotnitsky, Proctor, & Erickson, 2000;Wolfe, Schnurr, Brown, & Furey, 1994;Zoellner, Goodwin, & Foa, 2000) as well as a range of physician-diagnosed disorders such as cardiovascular/circulatory, autoimmune, musculoskeletal, digestive and respiratory disorders (Boscarino, 1997(Boscarino, , 2004Goodwin & Davidson, 2005;Ka...

show abstract

Posttraumatic Stress Disorder and Depression Following Trauma: Understanding Comorbidity

Abstract: While PTSD and comorbid PTSD/depression are indistinguishable, the findings support the existence of depression as a separate construct in the acute, but not the chronic, aftermath of trauma.

Cited by 625 publications

References 19 publications

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey-Replication (NCS-R)

Contact Info

Product

Resources

About