Impact of PTSD comorbidity on one-year outcomes in a depression trial

Bonnie L. Green*, Janice L. Krupnick, Joyce Chung, Juned Siddique, Elizabeth D. Krause, Dennis Revicki, Lori Frank, Jeanne Miranda

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

107 Scopus citations

Abstract

Low-income African American, Latino, and White women were screened and recruited for a depression treatment trial in social service and family planning settings. Those meeting full criteria for major depression (MDD; N = 267) were randomized to cognitive-behavior therapy (CBT), anti-depressant medication, or community mental health referral. All randomly assigned participants were evaluated by baseline telephone and clinical interview, and followed by telephone for one year. Posttraumatic stress disorder (PTSD) comorbidity was assessed at baseline and one-year follow-up in a clinical interview. At baseline, 33% of the depressed women had current comorbid PTSD. These participants had more exposure to assaultive violence, had higher levels of depression and anxiety, and were more functionally impaired than women with depression alone. Depression in both groups improved over the course of one year, but the PTSD subgroup remained more impaired throughout the one-year follow-up period. Thus, evidence-based treatments (antidepressant medication or structured psychotherapy) decrease depression regardless of PTSD comorbidity, but women with PTSD were more distressed and impaired throughout. Including direct treatment of PTSD associated with interpersonal violence may be more effective in alleviating depression in those with both diagnoses.

Original languageEnglish (US)
Pages (from-to)815-835
Number of pages21
JournalJournal of Clinical Psychology
Volume62
Issue number7
DOIs
StatePublished - Jul 2006

Keywords

  • African American women
  • CBT
  • Depression treatment
  • Latino women
  • Medication
  • Posttraumatic stress disorder

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Psychology

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