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Prevalence of Depression–PTSD Comorbidity: Implications for Clinical Practice Guidelines and Primary Care-based Interventions
Open accessAbstract
Background Compared to those with depression alone, depressed patients with posttraumatic stress disorder (PTSD) experience more severe psychiatric symptomatology and factors that complicate treatment. Objective To estimate PTSD prevalence among depressed military veteran primary care patients and compare demographic/illness characteristics of PTSD screen-positive depressed patients (MDD-PTSD+) to those with depression alone (MDD). Design Cross-sectional comparison of MDD patients versus MDD-PTSD+ patients. Participants Six hundred seventy-seven randomly sampled depressed patients with at least 1 primary care visit in the previous 12 months. Participants composed the baseline sample of a group randomized trial of collaborative care for depression in 10 VA primary care practices in 5 states. Measurements The Patient Health Questionnaire-9 assessed MDD. Probable PTSD was defined as a Primary Care PTSD Screen > or = 3. Regression-based techniques compared MDD and MDD-PTSD+ patients on demographic/illness characteristics. Results Thirty-six percent of depressed patients screened positive for PTSD. Adjusting for sociodemographic differences and physical illness comorbidity, MDD-PTSD+ patients reported more severe depression (P < .001), lower social support (P < .001), more frequent outpatient health care visits (P < .001), and were more likely to report suicidal ideation (P < .001) than MDD patients. No differences were observed in alcohol consumption, self-reported general health, and physical illness comorbidity. Conclusions PTSD is more common among depressed primary care patients than previously thought. Comorbid PTSD among depressed patients is associated with increased illness burden, poorer prognosis, and delayed response to depression treatment. Providers should consider recommending psychotherapeutic interventions for depressed patients with PTSD.
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“The comorbidity between PTSD and depression is supported by many studies (Bleich et al., 1997; Campbell et al., 2007; O’Donnell et al., 2014), so we assume that depression-related rumination is positively associated with PTSD.”
From Coexistence and different determinants of posttraumatic stress disorder and posttraumatic growth among Chinese survivors after earthquake: role of resilience and rumination (2015) · cites this paper as Campbell et al., 2007
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“It has been well-documented that people with post-traumatic stress disorder (PTSD) often suffer from co-occurring depression [7–9].”
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Choices in Gamification of Therapy for PTSD
Thomsen, D., Rye, J. M., & Ott, T. E. (2016) · IGI Global eBooks · doi:10.4018/978-1-5225-0159-6.ch055 · Cited by 1
“While effective treatments for PTSD already exist, Campbell et al. (2007) report that common PTSD complications such as substance abuse, anger, and depression, in addition to mundane barriers such as finding daycare, distance, missing work, and monetary costs, complicate individual patients’…”
BackgroundValidação do Patient Health Questionnaire (PHQ-8) numa Amostra de Militares
Vasconcelos-Raposo, J., Sousa, D. M., & Teixeira, C. M. (2022) · Revista Iberoamericana de Diagnóstico y Evaluación - e Avaliação Psicológica · doi:10.21865/ridep65.4.13 · Cited by 1
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“Further complicating the situation, with PTSD and co-morbid depression, a delay in treatment, increases the burden of illness substantially (Brady et al., 2000; Campbell et al., 2007).”
McDaniel, J. T., Ezigbo, U. G., & Copeland, L. C. R. P. (2025) · Journal of Religion & Spirituality in Social Work Social Thought · doi:10.1080/15426432.2025.2459828 · Cited by 1
Summary and Implications of Findings
Bray, R. M., Hourani, L. L., Williams, J. G., Lane, M. E., & Marsden, M. E. (2013) · Springer eBooks · doi:10.1007/978-0-387-78303-1_7 · Cited by 1
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Physical activity and mental distress among Veteran cancer survivors with heart disease and diabetes
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Case Reports of Complex Post Traumatic Stress Disorder: Based on Psychological Assessments
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Género y evaluación de experiencias traumáticas en víctimas de violencia política
Durán, R. E. V. (2010) · Gredos (University of Salamanca) · doi:10.14201/gredos.76593 · Cited by 1
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Psychosocial Intervention for Co-Existing MDD and PTSD
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“For example, in a multi-site study (N=677), Campbell et al [11] reported 36% of patients met criteria for PTSD and Major Depression.”
BackgroundDecision Making Skills Among Individuals with Disorders of Affect Regulation
Osterman, C. K. (2011) · doi:10.14418/wes01.1.666
“(Campbell et al., 2007). Fava et al. (2002) assessed 378 depressed outpatients before and after antidepressant treatment and found that prior to treatment, the most common co-morbid disorders were obsessive-compulsive disorder (30%), avoidant personality”
BackgroundSUICIDAL BEHAVIOUR IN POSTTRAUMATIC STRESS DISORDER
Panagioti, M. (2011) · Research Explorer (The University of Manchester)
Metadata
- Authors
- Campbell, D. G., Felker, B. L., Liu, C.-F., Yano, E. M., Kirchner, J. E., Chan, D., Rubenstein, L. V., & Chaney, E. F.
- Affiliations
- Health Services Research & Development (US)
- University of Washington (US)
- University of California, Los Angeles (US)
- Central Arkansas Veterans Healthcare System (US)
- RAND Corporation (US)
- Corresponding author
- Campbell, Duncan G.
- ORCID
- Venue
- Journal of General Internal Medicine
- Published
- 2007-01-24
- Volume
- 22
- Issue
- 6
- Pages
- 711-718
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC2219856
- OpenAlex
- W2030974975
- Cited by
- 458
- References
- 57
- Citations by year
- 2026: 15 · 2025: 24 · 2024: 14 · 2023: 19 · 2022: 25 · 2021: 29 · 2020: 34 · 2019: 39 · 2018: 34 · 2017: 37 · 2016: 36 · 2015: 31 · 2014: 26 · 2013: 30 · 2012: 14
- FWCI
- 10.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Pfizer
- RAND Corporation
- Health Services Research and Development
- University of Washington
- University of Montana
- University of California, Los Angeles
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- depression, post-traumatic stress disorder, PTSD prevalence, comorbidities, military veterans, primary care, collaborative care, suicidal ideation, social support, PHQ-9, PTSD screening, treatment response
- MeSH terms
- Aged, Cross-Sectional Studies, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Primary Health Care, Stress Disorders, Post-Traumatic, Veterans, Comorbidity, Prevalence, Practice Guidelines as Topic
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