Ten-year follow-up study of PTSD diagnosis, symptom severity and psychosocial indices in aging holocaust survivors.
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.
Yehuda
R
R
Division of Traumatic Stress Studies, Department of Psychiatry, Mount Sinai School of Medicine, New York, USA. rachel.yehuda@va.gov
Schmeidler
J
J
Labinsky
E
E
Bell
A
A
Morris
A
A
Zemelman
S
S
Grossman
R A
RA
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*
Am J Psychiatry. 1995 Jul;152(7):982-6
7793468
Int J Aging Hum Dev. 2005;60(3):229-48
15934215
Am J Psychiatry. 1997 Nov;154(11):1576-81
9356567
Ann N Y Acad Sci. 2006 Jul;1071:459-62
16891598
J Trauma Stress. 1997 Jul;10(3):453-63
9246652
Psychopharmacol Bull. 1973 Jan;9(1):13-28
4682398
J Trauma Stress. 2000 Jul;13(3):427-39
10948483
J Nerv Ment Dis. 2001 Dec;189(12):846-53
11794578
Am J Geriatr Psychiatry. 2007 Jan;15(1):79-83
17035355
Biol Psychiatry. 2006 Oct 1;60(7):714-21
17008144
J Gerontol. 1975 Jan;30(1):85-9
1109399
J Trauma Stress. 2004 Oct;17(5):403-11
15633919
J Psychiatr Res. 1975 Nov;12(3):189-98
1202204
Am J Psychiatry. 2001 Sep;158(9):1474-9
11532734
J Nerv Ment Dis. 1997 Nov;185(11):686-9
9368545
J Clin Psychol. 1989 Jan;45(1):80-7
2784447
Aging Ment Health. 2007 Mar;11(2):175-91
17453551
J Trauma Stress. 2003 Feb;16(1):39-47
12602651
J Clin Psychiatry. 2005 Aug;66(8):1031-7
16086619
Am J Psychiatry. 2006 Apr;163(4):659-66
16585441
Am J Psychiatry. 1994 Apr;151(4):554-9
8147453
Am J Psychiatry. 1986 Nov;143(11):1443-6
3777238
J Trauma Stress. 1995 Jan;8(1):75-90
7712061
Am J Psychiatry. 1995 Dec;152(12):1815-8
8526254
J Trauma Stress. 2007 Jun;20(3):281-9
17597125
Am J Geriatr Psychiatry. 2005 Aug;13(8):701-4
16085786
Psychol Aging. 1994 Mar;9(1):27-33
8185865