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Comorbidity of 9/11‐Related PTSD and Depression in the World Trade Center Health Registry 10–11 Years Postdisaster
Author(s) -
Caramanica Kimberly,
Brackbill Robert M.,
Liao Tim,
Stellman Steven D.
Publication year - 2014
Publication title -
journal of traumatic stress
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.259
H-Index - 134
eISSN - 1573-6598
pISSN - 0894-9867
DOI - 10.1002/jts.21972
Subject(s) - comorbidity , depression (economics) , psychiatry , mental health , medicine , patient health questionnaire , clinical psychology , depressive symptoms , anxiety , economics , macroeconomics
Many studies report elevated prevalence of posttraumatic stress disorder (PTSD) and depression among persons exposed to the September 11, 2001 (9/11) disaster compared to those unexposed; few have evaluated long‐term PTSD with comorbid depression. We examined prevalence and risk factors for probable PTSD, probable depression, and both conditions 10–11 years post‐9/11 among 29,486 World Trade Center Health Registry enrollees who completed surveys at Wave 1 (2003–2004), Wave 2 (2006–2007), and Wave 3 (2011–2012). Enrollees reporting physician diagnosed pre‐9/11 PTSD or depression were excluded. PTSD was defined as scoring ≥ 44 on the PTSD Checklist and depression as scoring ≥ 10 on the 8‐item Patient Health Questionnaire. We examined 4 groups: comorbid PTSD and depression, PTSD only, depression only, and neither. Among enrollees, 15.2% reported symptoms indicative of PTSD at Wave 3, 14.9% of depression, and 10.1% of both. Comorbid PTSD and depression was associated with high 9/11 exposures, low social integration, health‐related unemployment, and experiencing ≥ 1 traumatic life event post‐9/11. Comorbid persons experienced poorer outcomes on all PTSD‐related impairment measures, life satisfaction, overall health, and unmet mental health care need compared to those with only a single condition. These findings highlight the importance of ongoing screening and treatment for both conditions, particularly among those at risk for mental health comorbidity.