Comorbidity of PTSD and depression in Korean War veterans: Prevalence, predictors, and impairment

Monash Centre for Occupational and Environmental Health, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
Journal of Affective Disorders (Impact Factor: 3.71). 09/2010; 125(1-3):279-86. DOI: 10.1016/j.jad.2009.12.005
Source: PubMed

ABSTRACT Rates of PTSD and depression are high in Korean War veterans. The prevalence and impact of the two disorders occurring comorbidly, however, has not been investigated. This paper aims to investigate the extent to which PTSD and depression co-occur in Australian veterans of the Korean War, the symptom severity characteristics of comorbidity, the impact on life satisfaction and quality, and the association with war-related predictors.
Veterans (N=5352) completed self-report questionnaires including the Posttraumatic Stress Disorder Checklist, the Hospital Anxiety and Depression Scale, the Life Satisfaction Scale, the brief World Health Organisation Quality of Life questionnaire and the Combat Exposure Scale.
Seventeen percent of veterans met criteria for comorbid PTSD and depression, 15% had PTSD without depression, and a further 6% had depression without PTSD. Compared with either disorder alone, comorbidity was associated with impaired life satisfaction, reduced quality of life, and greater symptom severity. Several war-related factors were associated with comorbidity and with PTSD alone, but not with depression alone.
The reliance on self-reported measures and the necessity for retrospective assessment of some deployment-related factors renders some study data vulnerable to recall bias.
Comorbid PTSD and depression, and PTSD alone, are prevalent among Korean War veterans, are both associated with war-related factors 50 years after the Korean War, and may represent a single traumatic stress construct. The results have important implications for understanding complex psychopathology following trauma.

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    • "Genes have been identified that are common to both disorders (Koenen et al., 2008; Lawford et al., 2006). Co-occurrence of these two disorders is associated with diminished quality of life, reduced life satisfaction and increased severity of PTSD symptomatology (Ikin et al., 2010). Suicidal behaviour is more common in individuals suffering both disorders compared to those with depressive disorder alone (Oquendo et al., 2003). "
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