title: Posttraumatic stress disorder in outpatients with depression: Still a missed diagnosis.
abstract: Comorbidity between major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) is a well-established fact but has been studied little among MDD patients and even less among outpatients. We assessed the prevalence and characteristics of comorbid MDD-PTSD patients in a sample of MDD outpatients in an effort to elucidate possible causes of MDD-PTSD comorbidity. A semistructured clinical interview was applied to 101 outpatients with MDD. Sociodemographic factors, psychiatric history, the presence of PTSD, and MDD-PTSD comorbidity were recorded. The prevalence of MDD-PTSD comorbidity was 38.6%, with 26.7% suffering currently from PTSD. The average duration of PTSD was 16 years, and in most cases (79.5%) PTSD started earlier than or simultaneously with MDD. Only 28.8% of patients with PTSD had a documented diagnosis in their medical record. The most significant factors predicting MDD-PTSD comorbidity were found to be chronic depression, a history of prolonged or repeated trauma, male gender, a younger age at onset of psychological symptoms, lower education, and a lower level of functioning. Our findings indicate that MDD-PTSD comorbidity still remains an overlooked fact. Prolonged trauma seems to be a major risk factor for MDD-PTSD comorbidity, predisposing subjects to PTSD and later on or simultaneously to comorbidity with MDD.
authors.affiliation: a 1st Department of Psychiatry, Eginition Hospital , University of Athens Medical School , Athens , Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kostaras
authors.affiliation: a 1st Department of Psychiatry, Eginition Hospital , University of Athens Medical School , Athens , Greece.|b University Mental Health Research Institute , Athens , Greece.
authors.forename: Joanna-Despina
authors.initials: JD
authors.lastname: Bergiannaki
authors.affiliation: a 1st Department of Psychiatry, Eginition Hospital , University of Athens Medical School , Athens , Greece.
authors.forename: Constantin
authors.initials: C
authors.lastname: Psarros
authors.affiliation: a 1st Department of Psychiatry, Eginition Hospital , University of Athens Medical School , Athens , Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Ploumbidis
authors.affiliation: a 1st Department of Psychiatry, Eginition Hospital , University of Athens Medical School , Athens , Greece.|b University Mental Health Research Institute , Athens , Greece.
authors.forename: Charalambos
authors.initials: C
authors.lastname: Papageorgiou
mesh_terms: D015897:Comorbidity; D003865:Major Depressive Disorder / Q000523:psychology*; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology*
keywords: Comorbidity; depression; posttraumatic stress disorder