Document Detail


Comorbidity and course of psychiatric disorders in a community sample of former prisoners of war.
MedLine Citation:
PMID:  9842785     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The authors assessed DSM-III-R disorders among American former prisoners of war. Comorbidity, time of onset, and the relationship of trauma severity to complicated versus uncomplicated posttraumatic stress disorder (PTSD) were examined. METHOD: A community sample (N=262) of men exposed to combat and imprisonment was assessed by clinicians using the Structured Clinical Interview for DSM-III-R. RESULTS: The rates of comorbidity among the men with PTSD were lower than rates from community samples assessed by lay interviewers. Over one-third of the cases of lifetime PTSD were uncomplicated by another axis I disorder; over one-half of the cases of current PTSD were uncomplicated. PTSD almost always emerged soon after exposure to trauma. Lifetime PTSD was associated with increased risk of lifetime panic disorder, major depression, alcohol abuse/dependence, and social phobia. Current PTSD was associated with increased risk of current panic disorder, dysthymia, social phobia, major depression, and generalized anxiety disorder. Relative to PTSD, the onset of the comorbid disorders was as follows: major depression, predominantly secondary; alcohol abuse/dependence and agoraphobia, predominantly concurrent (same year); social phobia, equal proportions primary and concurrent; and panic disorder, equal proportions concurrent and secondary. Trauma exposure was comparable in the subjects with complicated and uncomplicated PTSD. CONCLUSIONS: The types of comorbid diagnoses and their patterns of onset were comparable to the diagnoses and patterns observed in other community samples. The findings support the validity of the PTSD construct; PTSD can be distinguished from comorbid disorders. Uncomplicated PTSD may be more common than previous studies suggest, particularly in clinician-assessed subjects exposed to severe trauma.
Authors:
B Engdahl; T N Dikel; R Eberly; A Blank
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American journal of psychiatry     Volume:  155     ISSN:  0002-953X     ISO Abbreviation:  Am J Psychiatry     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1998-12-15     Completed Date:  1998-12-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370512     Medline TA:  Am J Psychiatry     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1740-5     Citation Subset:  AIM; IM    
Affiliation:
Psychology Service, VA Medical Center, Minneapolis, MN 55417, USA. engdahl.brian@minneapolis.va.gov
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MeSH Terms
Descriptor/Qualifier:
Agoraphobia / diagnosis,  epidemiology
Alcoholism / diagnosis,  epidemiology
Comorbidity
Depressive Disorder / diagnosis,  epidemiology
Dysthymic Disorder / diagnosis,  epidemiology
Humans
Life Change Events
Male
Mental Disorders / diagnosis,  epidemiology*
Panic Disorder / diagnosis,  epidemiology
Prevalence
Prisoners / psychology*
Psychiatric Status Rating Scales / statistics & numerical data
Reproducibility of Results
Stress Disorders, Post-Traumatic / diagnosis,  epidemiology
War*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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