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Comorbidity of PTSD in anxiety and depressive disorders: Prevalence and shared risk factors
Abstract
The present study aims to assess comorbidity of posttraumatic stress disorder (PTSD) in anxiety and depressive disorders and to determine whether childhood trauma types and other putative independent risk factors for comorbid PTSD are unique to PTSD or shared with anxiety and depressive disorders. The sample of 2402 adults aged 18-65 included healthy controls, persons with a prior history of affective disorders, and persons with a current affective disorder. These individuals were assessed at baseline (T0) and 2 (T2) and 4 years (T4) later. At each wave, DSM-IV-TR based anxiety and depressive disorder, neuroticism, extraversion, and symptom severity were assessed. Childhood trauma was measured at T0 with an interview and at T4 with a questionnaire, and PTSD was measured with a standardized interview at T4. Prevalence of 5-year recency PTSD among anxiety and depressive disorders was 9.2%, and comorbidity, in particular with major depression, was high (84.4%). Comorbidity was associated with female gender, all types of childhood trauma, neuroticism, (low) extraversion, and symptom severity. Multivariable significant risk factors (i.e., female gender and child sexual and physical abuse) were shared among anxiety and depressive disorders. Our results support a shared vulnerability model for comorbidity of anxiety and depressive disorders with PTSD. Routine assessment of PTSD in patients with anxiety and depressive disorders seems warranted.
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“Finally, traumatic experiences are highly prevalent in mood and anxiety disorders, where in a recent sample of 2000 persons with mood and anxiety disorders, 91.2% of reported having experienced a potentially traumatic or bothersome life event (Spinhoven et al., 2014).”
From A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions (2016) · cites this paper as Spinhoven et al., 2014
In the citing paper
“This overlap may partly explain the significant association between PTSD symptom scores and depression scores reported in this study (Flory and Yehuda, 2015;Spinhoven et al., 2014;Greene et al., 2016).”
From Risk and protective factors affecting the symptom trajectory of posttraumatic stress disorder post-rape (2022) · cites this paper as Spinhoven et al., 2014
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Flory, J. D., & Yehuda, R. (2015) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2015.17.2/jflory · Cited by 629
Huh, H. J., Kim, K. H., Lee, H.-K., & Chae, J. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.02.009 · Cited by 342
“Similar results about internal consistency of physical neglect subscore were also shown in several previous studies (Paivio and Cramer, 2004; Scher et al., 2004; Spinhoven et al., 2014).”
ResultNetworks of Depression and Anxiety Symptoms Across Development
McElroy, E., Fearon, P. R. M., Belsky, J., Fonagy, P., & Patalay, P. (2018) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2018.05.027 · Cited by 215
“This may go some way to explain why etiological research has struggled to identify consistent unique risk factors, both biological and environmental, for depression and anxiety.(41,42)”
BackgroundSex differences in PTSD resilience and susceptibility: Challenges for animal models of fear learning
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Describing the Mental Health Profile of First Responders: A Systematic Review
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Metadata
- Authors
- Spinhoven, P., Penninx, B. W., van Hemert, A. M., de Rooij, M., & Elzinga, B. M.
- Affiliations
- Leiden University (NL)
- University Medical Center Groningen (NL)
- Corresponding author
- Spinhoven, Philip
- Venue
- Child Abuse & Neglect
- Publisher
- Elsevier BV
- Published
- 2014-08
- Volume
- 38
- Issue
- 8
- Pages
- 1320-1330
- ISSN
- 0145-2134 (ISSN-L)
- OpenAlex
- W2137565796
- Cited by
- 305
- References
- 57
- Citations by year
- 2026: 21 · 2025: 51 · 2024: 28 · 2023: 38 · 2022: 28 · 2021: 27 · 2020: 30 · 2019: 15 · 2018: 16 · 2017: 22 · 2016: 15 · 2015: 11 · 2014: 2
- FWCI
- 19.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Child Abuse & Neglect (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- VU Research Portal (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- post-traumatic stress disorder, PTSD comorbidity, anxiety disorders, depressive disorders, major depressive disorder, childhood trauma, child sexual abuse, child physical abuse, shared risk factors, neuroticism, extraversion, symptom severity, gender differences, prevalence
- MeSH terms
- Adolescent, Adult, Aged, Child Abuse, Depressive Disorder, Female, Humans, Male, Middle Aged, Netherlands, Psychiatric Status Rating Scales, Risk Factors, Stress Disorders, Post-Traumatic, Cohort Studies, Comorbidity, Prevalence, Logistic Models, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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