Skip to main content
Top
Published in: Community Mental Health Journal 2/2012

01-04-2012 | Brief Report

Effect of Depression on Recovery from PTSD

Authors: Ümit Tural, Emin Önder, Tamer Aker

Published in: Community Mental Health Journal | Issue 2/2012

Login to get access

Abstract

It has been suggested that the treatment strategy needs to be reviewed and changed if depression occurs in patients with posttraumatic stress disorder (PTSD). We analyzed data extracted from the Marmara Epidemiological Survey (MES) which had examined 683 survivors at 3 years after a devastating earthquake. Fifty three cases (40.5%) out of the 131 cases with PTSD had also been diagnosed with MDD. Comorbid PTSD and MDD group has significantly lower rates of recovery from PTSD in comparison to PTSD without MDD (26.4% vs. 47.4% respectively). Rates of past psychiatric disorder and past traumatic experience were significantly more frequent among the comorbid group. Moreover, comorbidity of PTSD and MDD was clearly associated with greater psychological distress, more severe PTSD, and diminished perceived social support. Past psychiatric disorder, General Health Questionnaire (GHQ-12) and Multidimensional Scale of Perceived Social Scale (MSPSS) total scores succeeded in predicting the comorbidity of PTSD and MDD significantly.
Literature
go back to reference Başoğlu, M., Kilic, C., Salcioglu, E., & Livanou, M. (2004). Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey: An epidemiological study. Journal of Traumatic Stress, 17, 133–141.PubMedCrossRef Başoğlu, M., Kilic, C., Salcioglu, E., & Livanou, M. (2004). Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey: An epidemiological study. Journal of Traumatic Stress, 17, 133–141.PubMedCrossRef
go back to reference Başoglu, M., Livanou, M., Crnobarić, C., Francisković, T., Suljić, E., Durić, D., et al. (2005). Psychiatric and cognitive effects of war in former yugoslavia: Association of lack of redress for trauma and posttraumatic stress reactions. Journal of the American Medical Association, 294, 580–590.PubMedCrossRef Başoglu, M., Livanou, M., Crnobarić, C., Francisković, T., Suljić, E., Durić, D., et al. (2005). Psychiatric and cognitive effects of war in former yugoslavia: Association of lack of redress for trauma and posttraumatic stress reactions. Journal of the American Medical Association, 294, 580–590.PubMedCrossRef
go back to reference Başoğlu, M., Şalıcıoğlu, E., Livanou, M., Ozeren, M., Aker, T., Kilic, C., et al. (2001). A study of the validity of a screening instrument for traumatic stress in earthquake survivors in Turkey. Journal of Traumatic Stress, 14, 491–509.PubMedCrossRef Başoğlu, M., Şalıcıoğlu, E., Livanou, M., Ozeren, M., Aker, T., Kilic, C., et al. (2001). A study of the validity of a screening instrument for traumatic stress in earthquake survivors in Turkey. Journal of Traumatic Stress, 14, 491–509.PubMedCrossRef
go back to reference Brady, K. T., Killeen, T. K., Brewerton, T., & Lucerini, S. (2000). Comorbidity of psychiatric disorders and posttraumatic stress disorder. Journal of Clinical Psychiatry, 61(Suppl 7), 22–32.PubMed Brady, K. T., Killeen, T. K., Brewerton, T., & Lucerini, S. (2000). Comorbidity of psychiatric disorders and posttraumatic stress disorder. Journal of Clinical Psychiatry, 61(Suppl 7), 22–32.PubMed
go back to reference Breslau, N., & Davis, G. C. (1992). Posttraumatic stress disorder in an urban population of young adults: Risk factors for chronicity. American Journal of Psychiatry, 149, 671–675.PubMed Breslau, N., & Davis, G. C. (1992). Posttraumatic stress disorder in an urban population of young adults: Risk factors for chronicity. American Journal of Psychiatry, 149, 671–675.PubMed
go back to reference Breslau, N., Davis, G. C., Andreski, P., & Peterson, E. (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48, 216–222.PubMedCrossRef Breslau, N., Davis, G. C., Andreski, P., & Peterson, E. (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48, 216–222.PubMedCrossRef
go back to reference Breslau, N., Davis, G. C., Peterson, E. L., & Schultz, L. (1997). Psychiatric sequelae of posttraumatic stress disorder in women. Archives of General Psychiatry, 54, 81–87.PubMedCrossRef Breslau, N., Davis, G. C., Peterson, E. L., & Schultz, L. (1997). Psychiatric sequelae of posttraumatic stress disorder in women. Archives of General Psychiatry, 54, 81–87.PubMedCrossRef
go back to reference Carlson, E. B., & Rosser-Hogan, R. (1991). Trauma experiences, posttraumatic stress, dissociation, and depression in Cambodian refugees. American Journal of Psychiatry, 148, 1548–1551.PubMed Carlson, E. B., & Rosser-Hogan, R. (1991). Trauma experiences, posttraumatic stress, dissociation, and depression in Cambodian refugees. American Journal of Psychiatry, 148, 1548–1551.PubMed
go back to reference Eker, D., Arkar, H., & Yaldız, H. (2001). Çok Boyutlu Algılanan Sosyal Destek Ölçeği’nin Gözden Geçirilmiş Formunun Faktör Yapısı, Geçerlik ve Güvenirliği [Factorial Structure, Validity, and Reliability of Revised Form of the Multidimensional Scale of Perceived Social Support]. Turk Psikiyatri Dergisi, 12, 17–25. Eker, D., Arkar, H., & Yaldız, H. (2001). Çok Boyutlu Algılanan Sosyal Destek Ölçeği’nin Gözden Geçirilmiş Formunun Faktör Yapısı, Geçerlik ve Güvenirliği [Factorial Structure, Validity, and Reliability of Revised Form of the Multidimensional Scale of Perceived Social Support]. Turk Psikiyatri Dergisi, 12, 17–25.
go back to reference Foa, E. B., Davidson, J. R. T., Frances, A., Culpepper, L., Ross, R., & Ross, D. (1999). The expert consensus guideline series. Treatment of posttraumatic stress disorder. Journal of Clinical Psychiatry, 60(suppl 16), 5–76. Foa, E. B., Davidson, J. R. T., Frances, A., Culpepper, L., Ross, R., & Ross, D. (1999). The expert consensus guideline series. Treatment of posttraumatic stress disorder. Journal of Clinical Psychiatry, 60(suppl 16), 5–76.
go back to reference Goldberg, D. P., & Williams, P. (1988). A user’s guide to the general health questionnaire. Windsor (UK): NFR/Nelson Publishing Company. Goldberg, D. P., & Williams, P. (1988). A user’s guide to the general health questionnaire. Windsor (UK): NFR/Nelson Publishing Company.
go back to reference Green, B. L., Grace, M., & Gleser, G. (1989). Multiple diagnoses in PTSD: The role of war stressors. Journal of Nervous and Mental Disease, 177, 329–335.PubMedCrossRef Green, B. L., Grace, M., & Gleser, G. (1989). Multiple diagnoses in PTSD: The role of war stressors. Journal of Nervous and Mental Disease, 177, 329–335.PubMedCrossRef
go back to reference Green, B. L., Krupnick, J. L., Chung, J., Siddique, J., Krause, E. D., Revicki, D., et al. (2006). Impact of PTSD comorbidity on one year outcomes in a depression trial. Journal of Clinical Psychology, 62, 815–835.PubMedCrossRef Green, B. L., Krupnick, J. L., Chung, J., Siddique, J., Krause, E. D., Revicki, D., et al. (2006). Impact of PTSD comorbidity on one year outcomes in a depression trial. Journal of Clinical Psychology, 62, 815–835.PubMedCrossRef
go back to reference Green, M. M., McFarlane, A. C., Hunter, C. E., & Griggs, W. M. (1993). Undiagnosed post traumatic stress disorder following motor vehicle accidents. Medical Journal of Australia, 159, 529–534.PubMed Green, M. M., McFarlane, A. C., Hunter, C. E., & Griggs, W. M. (1993). Undiagnosed post traumatic stress disorder following motor vehicle accidents. Medical Journal of Australia, 159, 529–534.PubMed
go back to reference Hauff, E., & Vaglum, P. (1994). Chronic posttraumatic stress disorder in Vietnamese refugees. Journal of Nervous and Mental Disease, 182, 85–90.PubMedCrossRef Hauff, E., & Vaglum, P. (1994). Chronic posttraumatic stress disorder in Vietnamese refugees. Journal of Nervous and Mental Disease, 182, 85–90.PubMedCrossRef
go back to reference Helzer, J. E., Robins, L. N., & McEvoy, L. (1987). Post-traumatic stress disorder in the general population. Findings of the epidemiologic catchment area survey. New England Journal of Medicine, 317, 1630–1634.PubMedCrossRef Helzer, J. E., Robins, L. N., & McEvoy, L. (1987). Post-traumatic stress disorder in the general population. Findings of the epidemiologic catchment area survey. New England Journal of Medicine, 317, 1630–1634.PubMedCrossRef
go back to reference Hisli, N. (1989). A study on validity of Beck depression inventory. Psikoloji Dergisi, 6, 118–122. (Turkish). Hisli, N. (1989). A study on validity of Beck depression inventory. Psikoloji Dergisi, 6, 118–122. (Turkish).
go back to reference Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.PubMedCrossRef Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.PubMedCrossRef
go back to reference Kılıç, C. (1996). General health questionnaire: the study of reliability and validity. Turk Psikiyatri Dergisi, 7, 3–9. Kılıç, C. (1996). General health questionnaire: the study of reliability and validity. Turk Psikiyatri Dergisi, 7, 3–9.
go back to reference Kılıç, C., & Göğüş, A. (1997). Composite International Diagnostic Interview: CIDI (Turkish version). Ankara: Nurol Press. (Turkish). Kılıç, C., & Göğüş, A. (1997). Composite International Diagnostic Interview: CIDI (Turkish version). Ankara: Nurol Press. (Turkish).
go back to reference Kılıç, C., & Ulusoy, M. (2003). Psychological effects of the November 1999 earthquake in Turkey: An epidemiological study. Acta Psychiatrica Scandinavica, 108, 232–238.PubMedCrossRef Kılıç, C., & Ulusoy, M. (2003). Psychological effects of the November 1999 earthquake in Turkey: An epidemiological study. Acta Psychiatrica Scandinavica, 108, 232–238.PubMedCrossRef
go back to reference Kroll, J., Habenicht, M., Mackenzie, T., Yang, M., Chan, S., Vang, T., et al. (1989). Depression and posttraumatic stress disorder in Southeast Asian refugees. American Journal of Psychiatry, 146, 1592–1597.PubMed Kroll, J., Habenicht, M., Mackenzie, T., Yang, M., Chan, S., Vang, T., et al. (1989). Depression and posttraumatic stress disorder in Southeast Asian refugees. American Journal of Psychiatry, 146, 1592–1597.PubMed
go back to reference Maes, M., Delmeire, L., Mylle, J., & Altamura, C. (2001). Risk and preventive factors of post-traumatic stress disorder (PTSD): Alcohol consumption and intoxication prior to a traumatic event diminishes the relative risk to develop PTSD in response to that trauma. Journal of Affective Disorders, 63, 113–121.PubMedCrossRef Maes, M., Delmeire, L., Mylle, J., & Altamura, C. (2001). Risk and preventive factors of post-traumatic stress disorder (PTSD): Alcohol consumption and intoxication prior to a traumatic event diminishes the relative risk to develop PTSD in response to that trauma. Journal of Affective Disorders, 63, 113–121.PubMedCrossRef
go back to reference McFarlane, A. C., & Papay, P. (1992). Multiple diagnoses in posttraumatic stress disorder in the victims of a natural disaster. Journal of Nervous and Mental Disease, 180, 498–504.PubMedCrossRef McFarlane, A. C., & Papay, P. (1992). Multiple diagnoses in posttraumatic stress disorder in the victims of a natural disaster. Journal of Nervous and Mental Disease, 180, 498–504.PubMedCrossRef
go back to reference Mollica, R. F., McInnes, K., Sarajlic, N., Lavelle, J., Sarajlic, I., & Massagli, M. P. (1999). Disability associated with psychiatric comorbidity and health status in Bosnaian refugees living in Croatia. Journal of the American Medical Association, 282, 433–439.PubMedCrossRef Mollica, R. F., McInnes, K., Sarajlic, N., Lavelle, J., Sarajlic, I., & Massagli, M. P. (1999). Disability associated with psychiatric comorbidity and health status in Bosnaian refugees living in Croatia. Journal of the American Medical Association, 282, 433–439.PubMedCrossRef
go back to reference Momartin, S., Silove, D., Manicavasagar, V., & Steel, Z. (2004a). Complicated grief in Bosnian refugees associations with posttraumatic stress disorder and depression. Comprehensive Psychiatry, 45, 475–482.PubMedCrossRef Momartin, S., Silove, D., Manicavasagar, V., & Steel, Z. (2004a). Complicated grief in Bosnian refugees associations with posttraumatic stress disorder and depression. Comprehensive Psychiatry, 45, 475–482.PubMedCrossRef
go back to reference Momartin, S., Silove, D., Manicavasagar, V., & Steel, Z. (2004b). Comorbidity of PTSD and depression: Associations with trauma exposure, symptom severity and functional impairment in Bosnian refugees resettled in Australia. Journal of Affective Disorders, 80, 231–238.PubMedCrossRef Momartin, S., Silove, D., Manicavasagar, V., & Steel, Z. (2004b). Comorbidity of PTSD and depression: Associations with trauma exposure, symptom severity and functional impairment in Bosnian refugees resettled in Australia. Journal of Affective Disorders, 80, 231–238.PubMedCrossRef
go back to reference Önder, E., Tural, Ü., Aker, T., Kılıç, C., & Erdoğan, S. (2006). Prevalence of psychiatric disorders three years after the 1999 earthquake in Turkey: Marmara Earthquake Survey (MES). Social Psychiatry and Psychiatric Epidemiology, 41, 868–874.PubMedCrossRef Önder, E., Tural, Ü., Aker, T., Kılıç, C., & Erdoğan, S. (2006). Prevalence of psychiatric disorders three years after the 1999 earthquake in Turkey: Marmara Earthquake Survey (MES). Social Psychiatry and Psychiatric Epidemiology, 41, 868–874.PubMedCrossRef
go back to reference Oquendo, M., Brent, D. A., Birmaher, B., Greenhill, L., Kolko, D., Stanley, B., et al. (2005). Posttraumatic stress disorder comorbid with major depression: Factors mediating the association with suicidal behavior. American Journal of Psychiatry, 62, 560–566.CrossRef Oquendo, M., Brent, D. A., Birmaher, B., Greenhill, L., Kolko, D., Stanley, B., et al. (2005). Posttraumatic stress disorder comorbid with major depression: Factors mediating the association with suicidal behavior. American Journal of Psychiatry, 62, 560–566.CrossRef
go back to reference Oquendo, M. A., Friend, J. M., Halberstram, B., Brodsky, B. S., Burke, A. K., Grunebaum, M. F., et al. (2003). Association of comorbid posttraumatic stress disorder and major depression with greater risk for suicidality. American Journal of Psychiatry, 160, 580–583.PubMedCrossRef Oquendo, M. A., Friend, J. M., Halberstram, B., Brodsky, B. S., Burke, A. K., Grunebaum, M. F., et al. (2003). Association of comorbid posttraumatic stress disorder and major depression with greater risk for suicidality. American Journal of Psychiatry, 160, 580–583.PubMedCrossRef
go back to reference Peters, L., Andrews, G., Cottler, L. B., Chatterjı, S., Janca, A., & Smeets, R. (1996). The composite international diagnostic interview post-traumatic stress disorder module: Preliminary data. International Journal of Methods in Psychiatric Research, 6, 167–174.CrossRef Peters, L., Andrews, G., Cottler, L. B., Chatterjı, S., Janca, A., & Smeets, R. (1996). The composite international diagnostic interview post-traumatic stress disorder module: Preliminary data. International Journal of Methods in Psychiatric Research, 6, 167–174.CrossRef
go back to reference Prigerson, H. G., Bierhals, A. J., Kasl, S. V., Reynolds, C. F., III, Shear, M. K., Day, N., et al. (1997). Traumatic grief as a risk factor for mental and physical morbidity. American Journal of Psychiatry, 154, 616–623.PubMed Prigerson, H. G., Bierhals, A. J., Kasl, S. V., Reynolds, C. F., III, Shear, M. K., Day, N., et al. (1997). Traumatic grief as a risk factor for mental and physical morbidity. American Journal of Psychiatry, 154, 616–623.PubMed
go back to reference Salcioglu, E., Basoglu, M., & Livanou, M. (2007). Post-traumatic stress disorder and comorbid depression among survivors of the 1999 earthquake in Turkey. Disasters, 31, 115–129.PubMedCrossRef Salcioglu, E., Basoglu, M., & Livanou, M. (2007). Post-traumatic stress disorder and comorbid depression among survivors of the 1999 earthquake in Turkey. Disasters, 31, 115–129.PubMedCrossRef
go back to reference Shalev, A. Y., Freedman, S., Peri, T., Brandes, D., Sahar, T., Orr, S. P., et al. (1998). Prospective study of posttraumatic stress disorder and depression following trauma. American Journal of Psychiatry, 155, 630–637.PubMed Shalev, A. Y., Freedman, S., Peri, T., Brandes, D., Sahar, T., Orr, S. P., et al. (1998). Prospective study of posttraumatic stress disorder and depression following trauma. American Journal of Psychiatry, 155, 630–637.PubMed
go back to reference The World Health Organization (WHO). (1992). The ICD–10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. Geneva: WHO. The World Health Organization (WHO). (1992). The ICD–10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. Geneva: WHO.
go back to reference Tural, Ü., Aybar Tolun, H. G., Karakaya, I., Erol, A., Yıldız, M., & Erdoğan, S. (2001). Marmara depremzedelerinde travma sonrası stres bozukluğuna eşlik eden başka bir ruhsal hastalık gelişiminin yordayıcıları (Predictors of current comorbid psychiatric disorders with posttraumatic stress disorder in earthquake survivors). Turk Psikiyatri Dergisi, 12, 175–183. Tural, Ü., Aybar Tolun, H. G., Karakaya, I., Erol, A., Yıldız, M., & Erdoğan, S. (2001). Marmara depremzedelerinde travma sonrası stres bozukluğuna eşlik eden başka bir ruhsal hastalık gelişiminin yordayıcıları (Predictors of current comorbid psychiatric disorders with posttraumatic stress disorder in earthquake survivors). Turk Psikiyatri Dergisi, 12, 175–183.
go back to reference Westermeyer, J., Vang, T. F., & Neider, J. (1983). Refugees who do and do not seek psychiatric care: an analysis of premigration and postmigration characteristics. Journal of Nervous and Mental Disease, 171, 86–91.PubMedCrossRef Westermeyer, J., Vang, T. F., & Neider, J. (1983). Refugees who do and do not seek psychiatric care: an analysis of premigration and postmigration characteristics. Journal of Nervous and Mental Disease, 171, 86–91.PubMedCrossRef
go back to reference Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52, 30–41.CrossRef Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52, 30–41.CrossRef
go back to reference Zlotnick, C., Warshaw, M., Shea, M. T., Allsworth, J., Pearlstein, T., & Keller, M. B. (1999). Chronicity in PTSD and predictors of course of comorbid PTSD in patients with anxiety disorders. Journal of Traumatic Stress, 12, 89–100.PubMedCrossRef Zlotnick, C., Warshaw, M., Shea, M. T., Allsworth, J., Pearlstein, T., & Keller, M. B. (1999). Chronicity in PTSD and predictors of course of comorbid PTSD in patients with anxiety disorders. Journal of Traumatic Stress, 12, 89–100.PubMedCrossRef
Metadata
Title
Effect of Depression on Recovery from PTSD
Authors
Ümit Tural
Emin Önder
Tamer Aker
Publication date
01-04-2012
Publisher
Springer US
Published in
Community Mental Health Journal / Issue 2/2012
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI
https://doi.org/10.1007/s10597-010-9359-4

Other articles of this Issue 2/2012

Community Mental Health Journal 2/2012 Go to the issue