Risk for suicidal behaviors associated with PTSD, depression, and their comorbidity in the U.S. Army

Ramsawh, Holly J.; Fullerton, Carol S.; Mash, Holly B. Herberman; Ng, Tsz Hin Hinz; Kessler, Ronald C.; Stein, Murray B.; Ursano, Robert J.

doi:10.1016/j.jad.2014.03.016

Cited by 150 publications

(81 citation statements)

References 60 publications

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“…Empirical findings have demonstrated a high rate of comorbidity between PTSD and depressive symptoms (O’Donnell, Creamer, & Pattison, 2004; Tekin et al, 2016). Ramsawh et al (2014) found that individuals with both PTSD and depression were 2.6 times more likely to have past-year suicidality than those with either diagnosis alone.…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

Cheng

Liang

et al. 2018

European Journal of Psychotraumatology

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Background: Many studies have reported the comorbidity of posttraumatic stress disorder (PTSD) and depression in children. However, the underlying relationship between PTSD and depression remains unclear.Objective: This study examines the relationship between PTSD and depressive symptoms in children who survived the Wenchuan earthquake in China.Methods: In total, 301 children were assessed at four months and then followed up at 29, 40 and 52 months after the disaster. The ages of the children ranged from 9.6–14.6 years old, and the sample included 157 males and 144 females. The children were assessed by using the University of California at Los Angeles PTSD reaction index for DSM-IV for PTSD symptoms and the Children’s Depression Inventory for depressive symptoms.Results: Comorbid PTSD and depressive symptoms were prevalent in 4.0, 3.3, 3.7 and 5.1% of the participants at times 1, 2, 3 and 4, respectively. The cross-lagged analysis indicated that PTSD symptoms at time 1 predicted depressive symptoms at time 2; depressive symptoms at time 1 predicted PTSD symptoms at time 2; depressive symptoms at time 2 predicted PTSD symptoms at time 3; and depressive symptoms at time 3 predicted PTSD symptoms at time 4. The findings also showed that being female, poor parental relationships and trauma exposure were risk factors for PTSD or depressive symptoms.Conclusions: The results suggest that the causal relationship between PTSD and depressive symptoms changes over time; the effects of PTSD symptoms tend to decrease, while those of depressive symptoms tend to increase. Two stages of the relationship between PTSD and depressive symptoms were observed, namely, that PTSD and depressive symptoms first influenced each other and then that depressive symptoms predicted PTSD. The results of our study also suggest that females with poor parental relationships and a high degree of trauma exposure are more likely to require intervention.

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Section: Introductionmentioning

confidence: 99%

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

Cheng

Liang

et al. 2018

European Journal of Psychotraumatology

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“…In women, ASR of suicide fluctuated dramatically as it goes beyond the rate of men in age groups [20][21][22][23][24][25][26][27][28][29] In age group 10 -19-years, suicide rate for women was always higher than men during the whole period of observation. The highest rising rate was seen in age group > 70 years by 58.2% increase in average (95% CI: +31.7 -+89.9) (Figure 2).…”

Section: Crude Rate In Age Groupsmentioning

confidence: 99%

“…War in this region of the world could be one of the dominant determinants for chronic psychological disorder, which leads to suicide attempt. Durable war causes post-traumatic stress disorder (PTSD) and its psychological pain increases the risk of suicide (19,20). Some studies showed the relationship between PTSD and suicide related thoughts among Kurds in the west of Iran (21).…”

Section: Introductionmentioning

confidence: 99%

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Silent Change of Suicide in the West of Iran (Kermanshah): Joinpoint Regression Analysis

Heidari

Khanjani

Haghdoost

2017

Iran Red Crescent Med J

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“…2 This risk of suicidal behavior exists independent of comorbid depression 3,4 and is present even when the symptoms of PTSD are subthreshold in meeting criteria for the full diagnosis.…”

Section: James F Pagel Ms MDmentioning

confidence: 99%

Treating Nightmares—Sleep Medicine and Posttraumatic Stress Disorder

Pagel

2015

Journal of Clinical Sleep Medicine

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Commentary on Seda et al. Comparative meta-analysis of prazosin and imagery rehearsal therapy for nightmare frequency, sleep quality, and posttraumatic stress. J Clin Sleep Med 2015;11:11-22. James F. Pagel, MS, MDUniversity of Colorado School of Medicine, Pueblo, CO P osttraumatic stress disorder (PTSD) is arguably the most physiologically dangerous of the diagnoses addressed by the fi eld of Sleep Medicine. Of major psychiatric and medical diagnoses, PTSD is associated with the highest risk for both successful and unsuccessful suicide attempts.1 For some at risk populations (e.g., psychiatrically hospitalized adolescent offspring of war-associated PTSD veterans), the prevalence of suicide attempts exceeds sixty percent.2 This risk of suicidal behavior exists independent of comorbid depression 3,4 and is present even when the symptoms of PTSD are subthreshold in meeting criteria for the full diagnosis.5 The personal and social tolls for PTSD extend beyond suicide. Individuals with PTSD are far more likely to engage in substance abuse and risk taking behaviors including aggressive driving.6,7 The social sequelae of PTSD include job loss, divorce, homelessness, as well as increased risks for child and domestic abuse, sexual assault, violent crime, and re-incarceration. 8PTSD is treated with a wide variety of medication and psychological therapies. The most commonly utilized approaches, based on governmental and military recommendations for therapy, include various approaches to exposure therapy coupled with antidepressant and antianxiety medication.9-11 Exposure therapy, as utilized in Critical Incidence Stress Debriefi ng (CISD), is the most commonly utilized behavioral therapy for PTSD. 11,12 Since, when applied acutely, CISD can lead to increased symptoms for some patients, the American Psychiatric Association has called into question its routine use.13 While this approach to therapy for PTSD has been shown to diminish PTSD symptomatology, none of the current therapies for PTSD have been shown to reduce the occurrence of PTSD when utilized acutely after trauma, or to reduce the chance that PTSD will become a lifelong disorder.14,15 For many severely traumatized individuals, symptoms of PTSD persist into extreme old age. 16Nightmares are the most commonly reported symptom of PTSD.17 Among therapists utilizing exposure therapy to treat PTSD, some have the perspective that nightmares of the traumatic experience may be therapeutic-a useful part of the re-experience approach to therapy. Based on this perspective, some overviews of PTSD diagnosis and therapy deemphasize the role of recurrent nightmares both as a symptom and as a component of the diagnosis. 18The fi eld of Sleep Medicine has suggested an alternative approach to treating PTSD: proposing that the recurrent nightmares of PTSD lead to insomnia and next-day waking distress that contributes to waking symptoms of PTSD.19 This approach fi ts with an overall perspective that treating insomnia in psychiatric disorders can have signifi cant benefi ts. This appa...

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Risk for suicidal behaviors associated with PTSD, depression, and their comorbidity in the U.S. Army

Cited by 150 publications

References 60 publications

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

Silent Change of Suicide in the West of Iran (Kermanshah): Joinpoint Regression Analysis

Treating Nightmares—Sleep Medicine and Posttraumatic Stress Disorder

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