Am J Psychiatry 1991; 148:179-183
Copyright © 1991 by American Psychiatric Association
Characterization of depression in war-related posttraumatic stress disorder
SM Southwick, R Yehuda and EL Giller Jr
National Center for Post-traumatic Stress Disorder, Yale University- West Haven VA Medical Center, CT 06515.
OBJECTIVE: Many patients with posttraumatic stress disorder (PTSD) have
symptoms of depression, but operationalized psychological constructs
related to depression have not been used extensively in characterizing
affective symptoms of PTSD. The authors' objective is to better
characterize the affective component of PTSD. METHOD: The subjects were 45
male psychiatric inpatients at a Veterans Administration medical center; 28
met DSM-III-R criteria for PTSD and 17 met Research Diagnostic Criteria
(RDC) for major depressive disorder. All of the subjects with PTSD were
Vietnam veterans. The 21-item Hamilton Rating Scale for Depression was used
to assess state measures of symptom severity, and the Depressive
Experiences Questionnaire was used to measure dimensions of dependency,
self-criticism, and self-efficacy. RESULTS: The mean total Hamilton scale
score of the patients with PTSD was nonsignificantly higher than that of
the patients with major depressive disorder; patients with PTSD had higher
scores on almost all individual Hamilton symptoms, particularly insomnia,
somatic anxiety, and diurnal variation. Patients with PTSD had
significantly higher scores on the self-criticism scale but not on the
dependency and self- efficacy scales of the Depressive Experiences
Questionnaire. The scores of patients with PTSD on the dependency and
self-criticism scales were negatively correlated. No significant
differences between patients with PTSD with and without concurrent major
depressive disorder were observed. CONCLUSIONS: Characterization of such
depressive dimensions of PTSD as dependency and self-criticism may have
important clinical implications.
