title: Posttraumatic stress and depression: potential pathways to disease burden among heart failure patients.
abstract: OBJECTIVE
  Posttraumatic stress disorder (PTSD) and Major Depressive Disorder (MDD) are associated with high disease burden. Pathways by which PTSD and MDD contribute to disease burden are not understood.
  
  
  METHODS
  Path analysis was used to examine pathways between PTSD symptoms, MDD symptoms, and disease burden among 251 low-income heart failure patients.
  
  
  METHODS
  In Model 1, we explored the independent relationship between PTSD and MDD symptoms on disease burden. In Model 2, we examined the association of PTSD symptoms and disease burden on MDD symptoms. We also examined indirect associations of PTSD symptoms on MDD symptoms, mediated by disease burden, and of PTSD symptoms on disease burden mediated by MDD symptoms.
  
  
  RESULTS
  Disease burden correlated with PTSD symptoms (r = .41; p < .001) and MDD symptoms (r = .43; p < .001) symptoms. Both models fit the data well and displayed comparable fit. MDD symptoms did not mediate the association of PTSD symptoms with disease burden. Disease burden did mediate the relationship between PTSD symptoms and MDD symptoms.
  
  
  CONCLUSIONS
  Results support the importance of detection of PTSD in individuals with disease. Results also provide preliminary models for testing longitudinal data in future studies.
authors.affiliation: a Behavioral Sciences Department , Rush University Medical Center , 1645 West Jackson Boulevard, Suite 400, Chicago , IL 60612 , USA.
authors.forename: April
authors.initials: A
authors.lastname: Taylor-Clift
authors.affiliation: a Behavioral Sciences Department , Rush University Medical Center , 1645 West Jackson Boulevard, Suite 400, Chicago , IL 60612 , USA.
authors.forename: Stevan E
authors.initials: SE
authors.lastname: Hobfoll
authors.affiliation: a Behavioral Sciences Department , Rush University Medical Center , 1645 West Jackson Boulevard, Suite 400, Chicago , IL 60612 , USA.
authors.forename: James I
authors.initials: JI
authors.lastname: Gerhart
authors.affiliation: b Lake Forest College , Young Hall 125, 555 Sheridan Road, Lake Forest , IL 60045 , USA.|c Preventive Medicine Department , Rush University Medical Center , 1700 West Van Buren Street, Suite 470, Chicago , IL 60612 , USA.
authors.forename: DeJuran
authors.initials: D
authors.lastname: Richardson
authors.affiliation: c Preventive Medicine Department , Rush University Medical Center , 1700 West Van Buren Street, Suite 470, Chicago , IL 60612 , USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Calvin
authors.affiliation: c Preventive Medicine Department , Rush University Medical Center , 1700 West Van Buren Street, Suite 470, Chicago , IL 60612 , USA.
authors.forename: Lynda H
authors.initials: LH
authors.lastname: Powell
mesh_terms: D002641:Chicago / Q000453:epidemiology; D002908:Chronic Disease; D015897:Comorbidity; D017281:Cost of Illness; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008297:Male; D011203:Poverty / Q000523:psychology; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology*
keywords: chronic disease burden; congestive heart failure; depression; path analysis; posttraumatic stress disorder