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Depression and PTSD Co-Morbidity: What are We Missing?

Liat Itzhaky1, Yafit Levin1, Henry Fingerhut, and Zahava Solomon

Background: Posttraumatic stress disorder (PTSD) and depression comorbidity is highly common. Many hypotheses concerning this relation have been raised but the pertinent issues, including the wide clinical picture of this comorbidity, are still not clear. The current study aims to bridge these gaps.

Method: We assessed PTSD, depression and comorbid indicators including dissociation, somatization, selfdestructive behavior and suicidality among Israeli Yom Kippur war veterans at three time points (N = 349, 287, 301).

Results: Dissociation, somatization, self-destructive behavior and suicidality were predicted separately by group (PTSD, depression and comorbidity) and time of measurement using ANOVA and Chi squared analyses. The ‘comorbidity’ group expressed significantly higher dissociation, somatization, self-destructive behavior and suicidality, revealing high vulnerability of this group. Somatization presented a curvilinear-like development, increasing between T1 and T2 and slightly declining at T3, especially among the ‘comorbidity’ group. Suicidality showed a constant increase along the three measurements, especially among the comorbidity group.

Conclusions: A PTSD/depression comorbidity is both highly prevalent and long lasting and is often expressed concurrently with other related symptomatology, which causes further suffering and makes it more complicated for treatment. Implications for policy makers are briefly discussed.