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Comorbid persistent lower respiratory symptoms and posttraumatic stress disorder 5–6 years post‐9/11 in responders enrolled in the World Trade Center Health Registry
Author(s) -
Friedman Stephen M.,
Farfel Mark R.,
Maslow Carey B.,
Cone James E.,
Brackbill Robert M.,
Stellman Steven D.
Publication year - 2013
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.22217
Subject(s) - medicine , comorbidity , mental health , psychiatry , quality of life (healthcare) , distress , posttraumatic stress , severity of illness , clinical psychology , nursing
Background Co‐occurrence of lower respiratory symptoms (LRS) and posttraumatic stress disorder (PTSD) has been increasingly recognized among responders and survivors of the World Trade Center (WTC) disaster. Information is limited on the degree which comorbidity intensifies symptoms and compromises quality of life across exposed groups. Methods Among responders who completed the first and second Registry surveys, measures of respiratory illness, psychological distress, and diminished quality of life were compared between responders comorbid for LRS and PTSD and responders with only LRS or PTSD. Results Of 14,388 responders, 40% of those with LRS and 57% of those with PTSD were comorbid. When demographic and WTC exposure‐related factors were controlled, comorbid responders compared to those with LRS alone were twice as likely to have frequent dyspnea and to have sought care for dyspnea. Compared to responders with PTSD alone, comorbid responders were 2.1 times more likely to report intense re‐experiencing of the disaster, 2.5 times more likely to express feelings of significant non‐specific psychological distress, and 1.4 times more likely to have received mental health care. Comorbid responders were approximately three times more likely to report only fair or poor general health and more than twice as likely to report being unable to perform usual activities for ≥14 of 30 days before interview. Conclusions Outcomes in comorbid responders were similar to or more severe than in comorbid survivors. Health care and disaster relief providers must suspect comorbid illness when evaluating responders' respiratory or mental illnesses and consider treatment for both. Am. J. Ind. Med. 56:1251–1261, 2013. © 2013 Wiley Periodicals, Inc.