title: Patterns of lifetime PTSD comorbidity: a latent class analysis.
abstract: BACKGROUND
  Posttraumatic stress disorder (PTSD) is associated with high rates of psychiatric comorbidity, most notably substance use disorders, major depression, and other anxiety disorders. However, little is known about how these disorders cluster together among people with PTSD, if disorder clusters have distinct etiologies in terms of trauma type, and if they confer greater burden over and above PTSD alone.
  
  
  METHODS
  Utilizing Latent Class Analysis, we tested for discrete patterns of lifetime comorbidity with PTSD following trauma exposure (n = 409). Diagnoses were based on the Structured Clinical Interview for DSM-IV (SCID). Next, we examined if gender, trauma type, symptom frequency, severity, and interference with everyday life were associated with the latent classes.
  
  
  RESULTS
  Three patterns of lifetime comorbidity with PTSD emerged: a class characterized by predominantly comorbid mood and anxiety disorders; a class characterized by predominantly comorbid mood, anxiety, and substance dependence; and a relatively pure low-comorbidity PTSD class. Individuals in both high comorbid classes had nearly two and a half times the rates of suicidal ideation, endorsed more PTSD symptom severity, and demonstrated a greater likelihood of intimate partner abuse compared to the low comorbidity class. Men were most likely to fall into the substance dependent class.
  
  
  CONCLUSIONS
  PTSD comorbidity clusters into a small number of common patterns. These patterns may represent an important area of study, as they confer distinct differences in risk and possibly etiology. Implications for research and treatment are discussed.
authors.affiliation: New York University School of Medicine, New York, NY, USA. Isaac.Galatzer-Levy@nyumc.org
authors.forename: Isaac R
authors.initials: IR
authors.lastname: Galatzer-Levy
authors.forename: Angela
authors.initials: A
authors.lastname: Nickerson
authors.forename: Brett T
authors.initials: BT
authors.lastname: Litz
authors.forename: Charles R
authors.initials: CR
authors.lastname: Marmar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology*; D016000:Cluster Analysis; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States; D055815:Young Adult