Article

Impact of PTSD comorbidity on one-year outcomes in a depression trial

Georgetown Center for Trauma and the Community, Georgetown University Medical Center, Washington, DC 20007, USA.
Journal of Clinical Psychology (Impact Factor: 2.12). 07/2006; 62(7):815-35. DOI: 10.1002/jclp.20279
Source: PubMed

ABSTRACT 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.

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    • "It is reasonable to suppose that using CPT to lessen the severity of co-occurring depression symptoms may lessen the rates of self-injurious behaviors and lethality among clients with PTSD. This finding is especially encouraging given that individuals who have both PTSD and depression may be less responsive to medication than those with depression alone (Green et al., 2006; Hollon et al., 2005). "
    10/2014; 36(4):360-376. DOI:10.17744/mehc.36.4.1360805271967kvq
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    • "The first step involves patient screening by the recruitment coordinator (RC) using a brief 6-item screener [71] to identify those at risk for PTSD. For those with a positive brief screen, the RC assesses patients for exposure to traumatic events using the Stressful Life Events Screening Questionnaire (SLES-Q) [10] [72] and administers the Clinician Administered PTSD Scale (CAPS) [73] [74] to assess for a diagnosis of PTSD (Step 2). Patients who meet the criteria for PTSD are randomized to either the CM intervention or usual care and then complete the baseline evaluation assessment. "
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    • "Co-occurrence of PTSD and depression increases illness burden, delays response to treatment of one type of problem, and impairs women's ability to fully utilize personal and social resources (Campbell et al., 2006; Gorde, Helfrich, & Finalyson, 2004; Green et al., 2006; Sullivan, & Bybee, 1999). In addition, women with co-occurring PTSD and depression problems have increased prevalence of suicide ideation and seek more frequent outpatient care for emotional problems (Green et al., 2006). Therefore, it is important to examine risk factors (e.g., severity of IPV) that are linked to co-occurrence of PTSD and depression among women, and protective factors (e.g., use of MH resources) that may help address their MH needs. "
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