title: Ten-year follow-up study of PTSD diagnosis, symptom severity and psychosocial indices in aging holocaust survivors.
abstract: OBJECTIVE
  We performed a longitudinal study of holocaust survivors with and without post-traumatic stress disorder (PTSD) by assessing symptoms and other measures at two intervals, approximately 10 years apart.
  
  
  METHODS
  The original cohort consisted of 63 community-dwelling subjects, of whom 40 were available for follow-up.
  
  
  RESULTS
  There was a general diminution in PTSD symptom severity over time. However, in 10% of the subjects (n=4), new instances of delayed onset PTSD developed between time 1 and time 2. Self-report ratings at both assessments revealed a worsening of trauma-related symptoms over time in persons without PTSD at time 1, but an improvement in those with PTSD at time 1.
  
  
  CONCLUSIONS
  The findings suggest that a nuanced characterization of PTSD trajectory over time is more reflective of PTSD symptomatology than simple diagnostic status at one time. The possibility of delayed onset trajectory complicates any simplistic overall trajectory summarizing the longitudinal course of PTSD.
authors.affiliation: Division of Traumatic Stress Studies, Department of Psychiatry, Mount Sinai School of Medicine, New York, USA. rachel.yehuda@va.gov
authors.forename: R
authors.initials: R
authors.lastname: Yehuda
authors.forename: J
authors.initials: J
authors.lastname: Schmeidler
authors.forename: E
authors.initials: E
authors.lastname: Labinsky
authors.forename: A
authors.initials: A
authors.lastname: Bell
authors.forename: A
authors.initials: A
authors.lastname: Morris
authors.forename: S
authors.initials: S
authors.lastname: Zemelman
authors.forename: R A
authors.initials: RA
authors.lastname: Grossman
mesh_terms: D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D003209:Concentration Camps; D003674:Defense Mechanisms; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007585:Jews / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D028683:National Socialism; D010552:Personality Assessment / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D055500:Resilience, Psychological; D012917:Social Adjustment; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D017741:Survivors / Q000523:psychology*
references.citation: Am J Psychiatry. 1995 Jul;152(7):982-6
references.pmid: 7793468
references.citation: Int J Aging Hum Dev. 2005;60(3):229-48
references.pmid: 15934215
references.citation: Am J Psychiatry. 1997 Nov;154(11):1576-81
references.pmid: 9356567
references.citation: Ann N Y Acad Sci. 2006 Jul;1071:459-62
references.pmid: 16891598
references.citation: J Trauma Stress. 1997 Jul;10(3):453-63
references.pmid: 9246652
references.citation: Psychopharmacol Bull. 1973 Jan;9(1):13-28
references.pmid: 4682398
references.citation: J Trauma Stress. 2000 Jul;13(3):427-39
references.pmid: 10948483
references.citation: J Nerv Ment Dis. 2001 Dec;189(12):846-53
references.pmid: 11794578
references.citation: Am J Geriatr Psychiatry. 2007 Jan;15(1):79-83
references.pmid: 17035355
references.citation: Biol Psychiatry. 2006 Oct 1;60(7):714-21
references.pmid: 17008144
references.citation: J Gerontol. 1975 Jan;30(1):85-9
references.pmid: 1109399
references.citation: J Trauma Stress. 2004 Oct;17(5):403-11
references.pmid: 15633919
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Am J Psychiatry. 2001 Sep;158(9):1474-9
references.pmid: 11532734
references.citation: J Nerv Ment Dis. 1997 Nov;185(11):686-9
references.pmid: 9368545
references.citation: J Clin Psychol. 1989 Jan;45(1):80-7
references.pmid: 2784447
references.citation: Aging Ment Health. 2007 Mar;11(2):175-91
references.pmid: 17453551
references.citation: J Trauma Stress. 2003 Feb;16(1):39-47
references.pmid: 12602651
references.citation: J Clin Psychiatry. 2005 Aug;66(8):1031-7
references.pmid: 16086619
references.citation: Am J Psychiatry. 2006 Apr;163(4):659-66
references.pmid: 16585441
references.citation: Am J Psychiatry. 1994 Apr;151(4):554-9
references.pmid: 8147453
references.citation: Am J Psychiatry. 1986 Nov;143(11):1443-6
references.pmid: 3777238
references.citation: J Trauma Stress. 1995 Jan;8(1):75-90
references.pmid: 7712061
references.citation: Am J Psychiatry. 1995 Dec;152(12):1815-8
references.pmid: 8526254
references.citation: J Trauma Stress. 2007 Jun;20(3):281-9
references.pmid: 17597125
references.citation: Am J Geriatr Psychiatry. 2005 Aug;13(8):701-4
references.pmid: 16085786
references.citation: Psychol Aging. 1994 Mar;9(1):27-33
references.pmid: 8185865