Keywords : trauma
Longitudinal study of PTSD and depression in a war-exposed sample – comorbidity increases distress and suicide risk
GLOBAL PSYCHIATRY ARCHIVES,
2020, Volume 3, Issue 1, Pages 64-71
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.
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.
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.
GLOBAL PSYCHIATRY ARCHIVES,
2020, Volume 2, Issue 1, Pages 97-106
Obesity is associated with several somatic diseases and increased psychological burden. This study focused on two potential psychological predictors of the body mass index (BMI), childhood trauma and depressive symptoms.
We used three independent populations: two general population samples (Study of Health in Pomerania, SHIP-2, N = 1,657; SHIP-TREND-0, N = 3,278) and one patient sample (GANI_MED, N = 1,742). Childhood trauma was measured with the childhood trauma questionnaire (CTQ) and depression with the Beck Depression Inventory (BDI-II) in SHIP-2 and the Patient Health Questionnaire (PHQ-9) in SHIP-TREND-0 and GANI_MED. We investigated the impact of childhood trauma and depression on BMI. Furthermore, we used mediation analysis to assess whether depression was a significant mediator on the path from childhood trauma to adult BMI in each of the three samples.
In all the three populations, depressive symptoms exhibited a significant association towards higher BMI (p < 0.05). Childhood trauma was positively associated with BMI with significant associations in SHIP-TREND-0 (p < 0.001) and GANI_MED (p = 0.005). The relationship between CTQ and BMI was significantly partially mediated (p < 0.05) by depressive symptoms in SHIP-TREND-0 (38.0%) and GANI_MED (16.4%), in SHIP-2 results pointed in the same direction. All the trauma sub-dimensions, except sexual abuse, exhibited at least one significant association towards increased BMI in one of the samples.
Childhood trauma and depressive symptoms may be considered as causes of obesity. These results suggest that psychological treatments against obesity should address childhood maltreatment as well as depressive symptoms in their diagnostic assessment and could facilitate psychotherapeutic treatment when necessary.