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Impact of PTSD comorbidity on one‐year outcomes in a depression trial
Author(s) -
Green Bonnie L.,
Krupnick Janice L.,
Chung Joyce,
Siddique Juned,
Krause Elizabeth D.,
Revicki Dennis,
Frank Lori,
Miranda Jeanne
Publication year - 2006
Publication title -
journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.124
H-Index - 119
eISSN - 1097-4679
pISSN - 0021-9762
DOI - 10.1002/jclp.20279
Subject(s) - comorbidity , psychology , depression (economics) , clinical psychology , psychiatry , macroeconomics , economics
Low‐income African American, Latino, and White women were screened and recruited for a depression treatment trial in social service and family planning settings. Those meeting full criteria for major depression (MDD; N = 267) were randomized to cognitive–behavior therapy (CBT), antidepressant medication, or community mental health referral. All randomly assigned participants were evaluated by baseline telephone and clinical interview, and followed by telephone for one year. Posttraumatic stress disorder (PTSD) comorbidity was assessed at baseline and one‐year follow‐up in a clinical interview. At baseline, 33% of the depressed women had current comorbid PTSD. These participants had more exposure to assaultive violence, had higher levels of depression and anxiety, and were more functionally impaired than women with depression alone. Depression in both groups improved over the course of one year, but the PTSD subgroup remained more impaired throughout the one‐year follow‐up period. Thus, evidence‐based treatments (antidepressant medication or structured psychotherapy) decrease depression regardless of PTSD comorbidity, but women with PTSD were more distressed and impaired throughout. Including direct treatment of PTSD associated with interpersonal violence may be more effective in alleviating depression in those with both diagnoses. © 2006 Wiley Periodicals, Inc. J Clin Psychol 62: 815–835, 2006.