Posttraumatic stress disorder and depression in battle-injured soldiers.
OBJECTIVE
This study examined rates, predictors, and course of probable posttraumatic stress disorder (PTSD) and depression among seriously injured soldiers during and following hospitalization.


METHODS
The patients were 613 U.S. soldiers hospitalized following serious combat injury. Standardized screening instruments were administered 1, 4, and 7 months following injury; 243 soldiers completed all three assessments. Cross-sectional and longitudinal analyses of risk factors were performed. PTSD was assessed with the PTSD Checklist; depression was assessed with the Patient Health Questionnaire. Combat exposure, deployment length, and severity of physical problems were also assessed.


RESULTS
At 1 month, 4.2% of the soldiers had probable PTSD and 4.4% had depression; at 4 months, 12.2% had PTSD and 8.9% had depression; at 7 months, 12.0% had PTSD and 9.3% had depression. In the longitudinal cohort, 78.8% of those positive for PTSD or depression at 7 months screened negative for both conditions at 1 month. High levels of physical problems at 1 month were significantly predictive of PTSD (odds ratio=9.1) and depression at 7 months (odds ratio=5.7) when the analysis controlled for demographic variables, combat exposure, and duration of deployment. Physical problem severity at 1 month was also associated with PTSD and depression severity at 7 months after control for 1-month PTSD and depression severity, demographic variables, combat exposure, and deployment length.


CONCLUSIONS
Early severity of physical problems was strongly associated with later PTSD or depression. The majority of soldiers with PTSD or depression at 7 months did not meet criteria for either condition at 1 month.
Grieger
Thomas A
TA
Department of Psychiatry, B-3074, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, USA. tgrieger@usuhs.mil
Cozza
Stephen J
SJ
Ursano
Robert J
RJ
Hoge
Charles
C
Martinez
Patricia E
PE
Engel
Charles C
CC
Wain
Harold J
HJ
D000328:Adult; D015331:Cohort Studies; D003130:Combat Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008889:Military Personnel; D010555:Personality Inventory; D012307:Risk Factors; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014728:Veterans; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000523:psychology