An in-depth look into PTSD-depression comorbidity: A longitudinal study of chronically-exposed Detroit residents.
Although PTSD-major depressive disorder (MDD) co-morbidity is well-established, the vast majority of studies have examined comorbidity at the level of PTSD total severity, rather than at the level of specific PTSD symptom clusters. This study aimed to examine the long-term associations between MDD and PTSD symptom clusters (intrusion, avoidance, hyperarousal), and the moderating role of gender in these associations.



942 residents of urban Detroit neighborhoods were interviewed at 3 waves, 1 year apart. At each wave, they were assessed for PTSD, depression, trauma exposure, and stressful life events.



At all waves, hyperarousal was the PTSD cluster most strongly correlated with MDD. For the full sample, a reciprocal relationship was found between MDD and all three PTSD clusters across time. Interestingly, the relative strength of associations between MDD and specific PTSD clusters changed over time. Women showed the same bidirectional MDD-PTSD pattern as in the entire sample, while men sometimes showed non-significant associations between early MDD and subsequent PTSD clusters.



First, our analyses are based on DSM-IV criteria, as this was the existing edition at the time of this study. Second, although this is a longitudinal study, inferences regarding temporal precedence of one disorder over another must be made with caution.



Early identification of either PTSD or MDD following trauma may be crucial in order to prevent the development of the other disorder over time. The PTSD cluster of hyper-arousal may require special therapeutic attention. Also, professionals are encouraged to develop more gender-specific interventions post-trauma.
Department of Psychology, Bar-Ilan University & Depratment of Psychiatry, NYU School of Medicine. Electronic address: danny.horesh@biu.ac.il.
Danny
D
Horesh
Department of Psychology, Montclair State University.
Sarah R
SR
Lowe
Boston University School of Public Health.
Sandro
S
Galea
Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Electronic address: aaiello@email.unc.edu.
Allison E
AE
Aiello
Department of Psychology, University of Illinois at Urbana-Champaign. Electronic address: muddin@illinois.edu.
Monica
M
Uddin
Department of Epidemiology, Harvard T.H. Chan School of Public Health. Electronic address: kkoenen@hsph.harvard.edu.
Karestan C
KC
Koenen
D000328:Adult; D015897:Comorbidity; D003863:Depression; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis; D005260:Female; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology
Comorbidity; Depression; Longitudinal study; Neighborhoods; PTSD