Cited by 458Posttraumatic Stress Disorder ResearchMigration, Health and TraumaMental Health Treatment and Access

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Prevalence of Depression–PTSD Comorbidity: Implications for Clinical Practice Guidelines and Primary Care-based Interventions

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Campbell, Duncan G., Felker, Bradford L., Liu, Chuan-Fen, Yano, Elizabeth M., Kirchner, JoAnn E., Chan, Domin, Rubenstein, Lisa V., Chaney, Edmund F.·2007·Journal of General Internal Medicine

DOI 10.1007/s11606-006-0101-4PMC PMC2219856

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Abstract

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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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: Campbell, Duncan G.
Felker, Bradford L.
Yano, Elizabeth M.
Kirchner, JoAnn E.
Rubenstein, Lisa V.
Chaney, Edmund F.
Venue: Journal of General Internal Medicine
Publisher: Springer Science and Business Media LLC
Published: 2007-01-24
Volume: 22
Issue: 6
Pages: 711-718
ISSN: 0884-8734 (ISSN-L)
1525-1497
DOI: 10.1007/s11606-006-0101-4
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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Prevalence of Depression–PTSD Comorbidity: Implications for Clinical Practice Guidelines and Primary Care-based Interventions

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