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Combat-Related Posttraumatic Stress Disorder and Comorbid Major Depression in U.S. Veterans: The Role of Deployment Cycle Adversity and Social Support |
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| Authors: | Elizabeth M Goetter Susanne S Hoeppner Amanda J Khan Meredith E Charney Sarah Wieman Margaret R Venners Kimberly M Avallone Sheila A M Rauch Naomi M Simon |
| Institution: | 1. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA;2. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA;3. San Francisco VA Medical Center, San Francisco, California, USA Department of Psychology, Suffolk University, Boston, Massachusetts, USA;4. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA Department of Psychology, Suffolk University, Boston, Massachusetts, USA;5. VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA;6. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA;7. VA Atlanta Healthcare System, Atlanta, Georgia, USA Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia, USA;8. Department of Psychiatry, New York University School of Medicine, New York, New York, USA NYU Langone Health, New York, New York, USA |
| Abstract: | Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) commonly co-occur in combat veterans, and this comorbidity has been associated with higher levels of distress and more social and economic costs compared to one disorder alone. In a secondary analysis of a multisite randomized controlled trial of a sample of veterans with combat-related PTSD, we examined the associations among pre-, peri-, and postdeployment adversity, social support, and clinician-diagnosed comorbid MDD. Participants completed the Deployment Risk and Resilience Inventory and the Beck Depression Inventory–II as well as structured clinical interviews for diagnostic status. Among 223 U.S. veterans of the military operations in Iraq and Afghanistan (86.9% male) with primary combat-related PTSD, 69.5% had current comorbid MDD. After adjustment for sex, a linear regression model indicated that more concerns about family disruptions during deployment, f2 = 0.065; more harassment during deployment, f2 = 0.020; and lower ratings of postdeployment social support, f2 = 0.154, were associated with more severe self-reported depression symptoms. Interventions that enhance social support as well as societal efforts to foster successful postdeployment reintegration are critical for reducing the mental health burden associated with this highly prevalent comorbidity in veterans with combat-related PTSD. |
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