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Review
. 2015 Jun;17(2):141-50.
doi: 10.31887/DCNS.2015.17.2/jflory.

Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations

Janine D Flory  1 , Rachel Yehuda  2
Affiliations
Review

Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations

Janine D Flory et al. Dialogues Clin Neurosci. 2015 Jun.

Abstract
in English, Spanish, French

Approximately half of people with post-traumatic stress disorder (PTSD) also suffer from Major Depressive Disorder (MDD). The current paper examines evidence for two explanations of this comorbidity. First, that the comorbidity reflects overlapping symptoms in the two disorders. Second, that the co-occurrence of PTSD and MDD is not an artifact, but represents a trauma-related phenotype, possibly a subtype of PTSD. Support for the latter explanation is inferred from literature that examines risk and biological correlates of PTSD and MDD, including molecular processes. Treatment implications of the comorbidity are considered.

Aproximadamente la mitad de las personas con trastorno por estrés postraumático (TEPT) también sufren de un trastorno depresivo mayor (TDM). Este artículo examina la evidencia para dos explicaciones de esta co-morbilidad. Primero, que la comorbilidad refleja una sobreposición de síntomas en los dos trastornos. Segundo, que la ocurrencia simultánea de TEPT y TDM no es un artefacto, sino que representa un fenotipo relacionado con el trauma, posiblemente un subtipo de TEPT. El soporte para esta última explicación se infiere de la literatura que revisa el riesgo y los correlatos biológicos del TEPT y el TDM, incluyendo los procesos moleculares. También se consideran las repercusiones terapéuticas de esta comorbilidad.

Environ la moitié des personnes qui présentent un trouble stress post-traumatique (TSPT) souffrent aussi d'un trouble dépressif caractérisé (majeur) (TDM). Cet article analyse les données relatives à deux explications de cette comorbidité. Premièrement, dans les deux troubles, la comorbidité révèle des symptômes de chevauchement. Deuxièmement, l'apparition concomitante d'un TSPT et d'un TDM n'est pas un artefact, mais représente un phénotype lié au traumatisme, probablement un sous-type de TSPT. La littérature, qui analyse le risque et les liens biologiques du TSPT et du TDM, y compris les processus moléculaires qui s'y rapportent, est en faveur de cette dernière explication. Nous examinons attentivement les implications thérapeutiques de cette comorbidité.

Keywords: FKBP5; MOD; PTSD; comorbidity; glucocorticoid receptor.

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References

    1. Breslau N., Davis GC., Peterson EL., Schultz L. Psychiatric sequelae of posttraumatic stress disorder in women. Arch Gen Psychiatry. 1997;54(1):81–87. - PubMed
    1. Caramanica K., Brackbill RM., Liao T., Stellman SD. Comorbidity of 9/11 -related PTSD and depression in the World Trade Center Health Registry 10-11 years postdisaster. J Trauma Stress. 2014;27(6):680–688. - PubMed
    1. Kessler RC., Sonnega A., Bromet E., Hughes M., Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52(12):1048–1060. - PubMed
    1. Rytwinski NK., Scur MD., Feeny NC., Youngstrom EA. The co-occurrence of major depressive disorder among individuals with posttraumatic stress disorder: a meta-analysis. J Trauma Stress. 2013;26(3):299–309. - PubMed
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington, DC: American Psychiatric Association; 1980

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