BACKGROUND: Compared to those with depression alone, depressed patients with posttraumatic stress disorder (PTSD) experience more severe psychiatric symptomatology and factors that complicate treatment. OBJECTIVE: To estimate PTSD prevalence among depressed military veteran primary care patients and compare demographic/illness characteristics of PTSD screen-positive depressed patients (MDD-PTSD+) to those with depression alone (MDD). DESIGN: Cross-sectional comparison of MDD patients versus MDD-PTSD+ patients. PARTICIPANTS: Six hundred seventy-seven randomly sampled depressed patients with at least 1 primary care visit in the previous 12 months. Participants composed the baseline sample of a group randomized trial of collaborative carefor depression in 10 VA primary care practices in 5 states. MEASUREMENTS: The Patient Health Questionnaire-9 assessed MDD. Probable PTSD was defined as a Primary Care PTSD Screen > or = 3. Regression-based techniques compared MDD and MDD-PTSD+ patients on demographic/illness characteristics. RESULTS: Thirty-six percent of depressed patients screened positive for PTSD. Adjusting for sociodemographic differences and physical illness comorbidity, MDD-PTSD+ patients reported more severe depression (P < .001), lower social support (P < .001), more frequent outpatient health care visits (P < .001), and were more likely to report suicidal ideation (P < .001) than MDD patients. No differences were observed in alcohol consumption, self-reported general health, and physical illness comorbidity. CONCLUSIONS: PTSD is more common among depressed primary care patients than previously thought. Comorbid PTSD among depressed patients is associated with increased illness burden, poorer prognosis, and delayed response to depression treatment. Providers should consider recommending psychotherapeutic interventions for depressed patients with PTSD.
RCT Entities:
BACKGROUND: Compared to those with depression alone, depressedpatients with posttraumatic stress disorder (PTSD) experience more severe psychiatric symptomatology and factors that complicate treatment. OBJECTIVE: To estimate PTSD prevalence among depressed military veteran primary care patients and compare demographic/illness characteristics of PTSD screen-positive depressedpatients (MDD-PTSD+) to those with depression alone (MDD). DESIGN: Cross-sectional comparison of MDDpatients versus MDD-PTSD+ patients. PARTICIPANTS: Six hundred seventy-seven randomly sampled depressedpatients with at least 1 primary care visit in the previous 12 months. Participants composed the baseline sample of a group randomized trial of collaborative care for depression in 10 VA primary care practices in 5 states. MEASUREMENTS: The Patient Health Questionnaire-9 assessed MDD. Probable PTSD was defined as a Primary Care PTSD Screen > or = 3. Regression-based techniques compared MDD and MDD-PTSD+ patients on demographic/illness characteristics. RESULTS: Thirty-six percent of depressedpatients screened positive for PTSD. Adjusting for sociodemographic differences and physical illness comorbidity, MDD-PTSD+ patients reported more severe depression (P < .001), lower social support (P < .001), more frequent outpatient health care visits (P < .001), and were more likely to report suicidal ideation (P < .001) than MDDpatients. No differences were observed in alcohol consumption, self-reported general health, and physical illness comorbidity. CONCLUSIONS:PTSD is more common among depressed primary care patients than previously thought. Comorbid PTSD among depressedpatients is associated with increased illness burden, poorer prognosis, and delayed response to depression treatment. Providers should consider recommending psychotherapeutic interventions for depressedpatients with PTSD.
Authors: Anouk L Grubaugh; Kathryn M Magruder; Angela E Waldrop; Jon D Elhai; Rebecca G Knapp; B Christopher Frueh Journal: J Nerv Ment Dis Date: 2005-10 Impact factor: 2.254
Authors: B N Gaynes; K M Magruder; B J Burns; H R Wagner; K S Yarnall; W E Broadhead Journal: Gen Hosp Psychiatry Date: 1999 May-Jun Impact factor: 3.238
Authors: Mark Olfson; Steven C Marcus; Benjamin Druss; Lynn Elinson; Terri Tanielian; Harold Alan Pincus Journal: JAMA Date: 2002-01-09 Impact factor: 56.272
Authors: Carolyn L Turvey; Yeates Conwell; Michael P Jones; Caroline Phillips; Eleanor Simonsick; Jane L Pearson; Robert Wallace Journal: Am J Geriatr Psychiatry Date: 2002 Jul-Aug Impact factor: 4.105
Authors: Martha L Bruce; Thomas R Ten Have; Charles F Reynolds; Ira I Katz; Herbert C Schulberg; Benoit H Mulsant; Gregory K Brown; Gail J McAvay; Jane L Pearson; George S Alexopoulos Journal: JAMA Date: 2004-03-03 Impact factor: 56.272
Authors: Matthew G Kirkpatrick; Nicholas I Goldenson; Nahel Kapadia; Christopher W Kahler; Harriet de Wit; Robert M Swift; John E McGeary; Steve Sussman; Adam M Leventhal Journal: Psychopharmacology (Berl) Date: 2015-10-02 Impact factor: 4.530
Authors: M Alexandra Kredlow; Kristin L Szuhany; Stephen Lo; Haiyi Xie; Jennifer D Gottlieb; Stanley D Rosenberg; Kim T Mueser Journal: Psychiatry Res Date: 2017-01-04 Impact factor: 3.222
Authors: Bushra Sabri; Richelle Bolyard; Akosoa L McFadgion; Jamila K Stockman; Marguerite B Lucea; Gloria B Callwood; Catherine R Coverston; Jacquelyn C Campbell Journal: Soc Work Health Care Date: 2013
Authors: Josefin Sundin; Nicola T Fear; Lisa Hull; Norman Jones; Christopher Dandeker; Matthew Hotopf; Simon Wessely; Roberto J Rona Journal: Int Arch Occup Environ Health Date: 2010-01-06 Impact factor: 3.015