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. 2019 Dec 13;19(1):396.
doi: 10.1186/s12888-019-2375-1.

Longitudinal trajectories of comorbid PTSD and depression symptoms among U.S. service members and veterans

Richard F Armenta  1   2   3 , Kristen H Walter  4   5 , Toni Rose Geronimo-Hara  4   6 , Ben Porter  4   6 , Valerie A Stander  6 , Cynthia A LeardMann  4   6 ; Millennium Cohort Study Team
Collaborators, Affiliations

Longitudinal trajectories of comorbid PTSD and depression symptoms among U.S. service members and veterans

Richard F Armenta et al. BMC Psychiatry. .

Abstract

Background: Posttraumatic stress disorder (PTSD) often co-occurs with other psychiatric disorders, particularly major depressive disorder (MDD). The current study examined longitudinal trajectories of PTSD and MDD symptoms among service members and veterans with comorbid PTSD/MDD.

Methods: Eligible participants (n = 1704) for the Millennium Cohort Study included those who screened positive at baseline for both PTSD (PTSD Checklist-Civilian Version) and MDD (Patient Health Questionnaire). Between 2001 and 2016, participants completed a baseline assessment and up to 4 follow-up assessments approximately every 3 years. Mixture modeling simultaneously determined trajectories of comorbid PTSD and MDD symptoms. Multinomial regression determined factors associated with latent class membership.

Results: Four distinct classes (chronic, relapse, gradual recovery, and rapid recovery) described symptom trajectories of PTSD/MDD. Membership in the chronic class was associated with older age, service branch, deployment with combat, anxiety, physical assault, disabling injury/illness, bodily pain, high levels of somatic symptoms, and less social support.

Conclusions: Comorbid PTSD/MDD symptoms tend to move in tandem, and, although the largest class remitted symptoms, almost 25% of participants reported chronic comorbid symptoms across all time points. Results highlight the need to assess comorbid conditions in the context of PTSD. Future research should further evaluate the chronicity of comorbid symptoms over time.

Keywords: Comorbidity; Major depressive disorder; Military personnel; Posttraumatic stress disorder; Veterans.

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Conflict of interest statement

The authors declare that they have no competing interests. I am a military service member or employee of the U.S. Government. This work was prepared as part of my official duties. Title 17, U.S.C. §105 provides that copyright protection under this title is not available for any work of the U.S. Government. Title 17, U.S.C. §101 defines a U.S. Government work as work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties. Report No. 19–40 was supported by the Military Operational Medicine Research Program under work unit no. 60002. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government. The study protocol was approved by the Naval Health Research Center Institutional Review Board in compliance with all applicable Federal regulations governing the protection of human subjects. Research data were derived from an approved Naval Health Research Center, Institutional Review Board protocol number NHRC.2000.0007.

Figures

Fig. 1
Fig. 1
Joint trajectories of comorbid posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) adjusted for covariates in the model. Black indicates trajectories for MDD and gray indicates trajectories for PTSD. All participants screened positive for comorbid PTSD/MDD at time 1. Each time point is approximately 3 years apart. Abbreviations: PCL-C, PTSD Checklist–Civilian Version; PHQ-8: Patient Health Questionnaire 8-item depression scale. Gray line: PTSD. Black line: MDD
See this image and copyright information in PMC

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