Posttraumatic Stress Symptoms and Associated Comorbidity During the COVID‐19 Pandemic in Ireland: A Population‐Based Study

Abstract

The prevalence of posttraumatic stress disorder (PTSD) as it relates to individuals’ experiences of the COVID‐19 pandemic has yet to be determined. This study was conducted to determine rates of COVID‐19–related PTSD in the Irish general population, the level of comorbidity with depression and anxiety, and the sociodemographic risk factors associated with COVID‐19–related PTSD. A nationally representative sample of adults from the general population of the Republic of Ireland (N = 1,041) completed self‐report measures of all study variables. The rate of COVID‐19–related PTSD was 17.7% (n = 184), 95% CI [15.35%, 19.99%], and there was a high level of comorbidity with generalized anxiety (49.5%) and depression (53.8%). Meeting the diagnostic requirement for COVID‐19–related PTSD was associated with younger age, male sex, living in a city, living with children, moderate and high perceived risk of COVID‐19 infection, and screening positive for anxiety or depression. Posttraumatic stress symptoms related to the COVID‐19 pandemic are common in the general population. Our results show that health professionals responsible for responding to the COVID‐19 pandemic should expect to routinely encounter symptoms and concerns related to posttraumatic stress.

Is Posttraumatic Stress Disorder Meaningful in the Context of the COVID‐19 Pandemic? A Response to Van Overmeire's Commentary on Karatzias et al. (2020)

“…When considering what measures of mental health to use, vigorous discussions took place about whether posttraumatic stress disorder (PTSD) was a meaningful construct in the context of the COVID-19 pandemic. We concluded that it was, and we have recently published findings from the first wave of our study in the Republic of Ireland in this journal (Karatzias et al, 2020), reporting that 17.7% of a nationally representative sample of the general adult population (N = 1,041) met the diagnostic requirements for PTSD. Subsequently, Van Overmeire (2020) has raised concerns about the validity of our findings, arguing that simply experiencing the COVID-19 pandemic is not sufficient to meet the trauma exposure criterion for a PTSD diagnosis and, consequently, our estimated PTSD prevalence figure was severely inflated.…”

“…In a recently published study in this journal that used a population-based sample in the Republic of Ireland (Karatzias et al, 2020), we concluded that 17.7% of the sample met the diagnostic requirements for COVID-19-related posttraumatic stress disorder (PTSD). Subsequently, Van Overmeire (2020) has raised concerns about the validity of our findings, arguing that simply experiencing the COVID-19 pandemic is not sufficient to meet the trauma exposure criterion for a PTSD diagnosis and, consequently, our estimated PTSD prevalence figure was inflated.…”

Association of PTSD with COVID-19 testing and infection in the Veterans Health Administration

“…These concerns are supported by historical evidence of trauma symptoms following prior pandemics, such as the 2003 severe acute respiratory syndrome (SARS) outbreak ( Mak et al, 2009 ). Early data from the COVID-19 pandemic suggest increased prevalence of PTSD and trauma symptoms in the general population since the onset of COVID-19 ( Bo et al, 2020 ; Boyraz & Legros, 2020 ; Karatzias et al, 2020 ). PTSD prevalence is particularly high among people in self-isolation ( Wu et al, 2020 ), demonstrating the adverse impacts of reduced social interaction.…”

The Methodological Problem of Identifying Criterion A Traumatic Events During the COVID‐19 Era: A Commentary on Karatzias et al. (2020)

“…The danger of applying PTSD criteria without considering the event is that overestimations might occur, which was previously noted by Durodié and Wainwright (2019) in their review of studies on terrorism that use PTSD symptom scales. Karatzias et al (2020) argue that there is a rationale for using such a broad and abstract event as the "COVID-19 experience" as the basis for a study on the association between COVID-19 and PTSD. The authors state that:…”

“…When trying to study the impact of the "COVID-19 experience," we should perhaps start to look at other diagnoses; for example, an adjustment disorder might be more appropriate. As there is no concrete event to which all symptoms can be tied, PTSD is likely not suitable for the goal studies such as that by Karatzias et al (2020) aim to achieve.…”