title: Impact of PTSD comorbidity on one-year outcomes in a depression trial.
abstract: Low-income African American, Latino, and White women were screened and recruited for a depression treatment trial in social service and family planning settings. Those meeting full criteria for major depression (MDD; N = 267) were randomized to cognitive-behavior therapy (CBT), antidepressant medication, or community mental health referral. All randomly assigned participants were evaluated by baseline telephone and clinical interview, and followed by telephone for one year. Posttraumatic stress disorder (PTSD) comorbidity was assessed at baseline and one-year follow-up in a clinical interview. At baseline, 33% of the depressed women had current comorbid PTSD. These participants had more exposure to assaultive violence, had higher levels of depression and anxiety, and were more functionally impaired than women with depression alone. Depression in both groups improved over the course of one year, but the PTSD subgroup remained more impaired throughout the one-year follow-up period. Thus, evidence-based treatments (antidepressant medication or structured psychotherapy) decrease depression regardless of PTSD comorbidity, but women with PTSD were more distressed and impaired throughout. Including direct treatment of PTSD associated with interpersonal violence may be more effective in alleviating depression in those with both diagnoses.
authors.affiliation: Georgetown Center for Trauma and the Community, Georgetown University Medical Center, Washington, DC 20007, USA. bgreen01@georgetown.edu
authors.forename: Bonnie L
authors.initials: BL
authors.lastname: Green
authors.forename: Janice L
authors.initials: JL
authors.lastname: Krupnick
authors.forename: Joyce
authors.initials: J
authors.lastname: Chung
authors.forename: Juned
authors.initials: J
authors.lastname: Siddique
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Krause
authors.forename: Dennis
authors.initials: D
authors.lastname: Revicki
authors.forename: Lori
authors.initials: L
authors.lastname: Frank
authors.forename: Jeanne
authors.initials: J
authors.lastname: Miranda
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents