Longitudinal study of PTSD and depression in a war-exposed sample – comorbidity increases distress and suicide risk

Abstract

Abstract Background Major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) are the most common mental disorders following traumatic experiences. The aim of this study was to investigate the extent to which PTSD and depression co-occurred in Serbian general population at baseline and 1 year after the follow-up, as well as how this co-occurrence was associated with sociodemographic factors, personal distress, suicidality and quality of life. Subjects and methods The sample consisted of 159 subjects, who fulfilled the IES criteria for PTSD, and were taken from a larger sample of 640 participants, which was chosen by a random walk technique in five regions of the country affected by major trauma. The assessment was carried out by the following instruments: Mini International Neuropsychiatric Interview 5 (MINI 5), Life Stressor Checklist-Revised (BSC-R), Brief Symptom Inventory (BSI), Impact of Event Scale-Revised (IES-R) and Manchester Short Assessment of Quality of Life Scale (MANSA). The follow-up study was carried out 1 year after the baseline. Results In the initial phase, PTSD was found in 100 out of 159 participants (62.9%), while 81 (51%) fulfilled the diagnostic criteria for MDD. Comorbidity of PTSD and depression was identified in 65 (40.9%) subjects of the sample. After 1 year, PTSD was found in 56 (35.2%) and MDD in 73 (45.9%) participants. Comorbidity of PTSD and depression in the follow-up phase was identified in 41 (25.8%) subjects of the sample. The subjects with comorbidity had significantly higher level of post-traumatic stress symptoms, general psychological distress as well as suicide risk and lower level of quality of life than participants with either condition alone. Conclusion PTSD–depression comorbidity is a common post-traumatic condition. Complex psychopathology, severity of symptoms and their consequences, both at individual and community levels, require attention to be paid to early diagnostics and treatment of affected persons.