Posttraumatic Stress Disorder and Depression in Battle-Injured Soldiers

• Published in: The American journal of psychiatry 2006-10, Vol.163 (10), p.1777-1783
• Main Authors: Grieger, Thomas A., Cozza, Stephen J., Ursano, Robert J., Hoge, Charles, Martinez, Patricia E., Engel, Charles C., Wain, Harold J.
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Anxiety disorders. Neuroses; Biological and medical sciences; Cohort Studies; Combat Disorders - diagnosis; Combat Disorders - epidemiology; Comorbidity; Cross-Sectional Studies; Depression; Depressive Disorder - diagnosis; Depressive Disorder - epidemiology; Depressive Disorder - psychology; Female; Health Status; Hospitalization; Hospitals; Humans; Life Change Events; Longitudinal Studies; Male; Medical sciences; Medical treatment; Military Personnel; Mood disorders; Patients; Personality Inventory; Post-traumatic stress disorder; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk Factors; Severity of Illness Index; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - epidemiology; Surveys and Questionnaires; Trauma centers; Trauma Severity Indices; United States - epidemiology; Veterans; War; Wounds and Injuries - epidemiology; Wounds and Injuries - psychology
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/ajp.2006.163.10.1777

Objective: This study examined rates, predictors, and course of probable posttraumatic stress disorder (PTSD) and depression among seriously injured soldiers during and following hospitalization. Method: The patients were 613 U.S. soldiers hospitalized following serious combat injury. Standardized screening instruments were administered 1, 4, and 7 months following injury; 243 soldiers completed all three assessments. Cross-sectional and longitudinal analyses of risk factors were performed. PTSD was assessed with the PTSD Checklist; depression was assessed with the Patient Health Questionnaire. Combat exposure, deployment length, and severity of physical problems were also assessed. Results: At 1 month, 4.2% of the soldiers had probable PTSD and 4.4% had depression; at 4 months, 12.2% had PTSD and 8.9% had depression; at 7 months, 12.0% had PTSD and 9.3% had depression. In the longitudinal cohort, 78.8% of those positive for PTSD or depression at 7 months screened negative for both conditions at 1 month. High levels of physical problems at 1 month were significantly predictive of PTSD (odds ratio=9.1) and depression at 7 months (odds ratio=5.7) when the analysis controlled for demographic variables, combat exposure, and duration of deployment. Physical problem severity at 1 month was also associated with PTSD and depression severity at 7 months after control for 1-month PTSD and depression severity, demographic variables, combat exposure, and deployment length. Conclusions: Early severity of physical problems was strongly associated with later PTSD or depression. The majority of soldiers with PTSD or depression at 7 months did not meet criteria for either condition at 1 month.