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PTSD Symptoms and Comorbid Mental Disorders in Israeli War Veterans

Published online by Cambridge University Press:  02 January 2018

Andrew E. Skodol*
Affiliation:
Columbia University and New York State Psychiatric Institute, New York
Sharon Schwartz
Affiliation:
School of Public Health, Columbia University
Bruce P. Dohrenwend
Affiliation:
Columbia University and New York State Psychiatric Institute
Itzhak Levav
Affiliation:
Brown University
Patrick E. Shrout
Affiliation:
Department of Psychology, New York University
Marian Reiff
Affiliation:
School of Public Health, Columbia University, New York
*
Andrew Skodol, New York State Psychiatric Institute, Box 8, 722 W. 168th St., New York, NY 10032, USA

Abstract

Background

The purpose of this study was to investigate patterns of mental disorders comorbid with PTSD symptoms in young Israeli men exposed to combat.

Method

Six hundred and seventeen subjects were selected via a general population sample and evaluated in a two-phase case-identification procedure, culminating in a modified SADS–L interview, administered by psychiatrists.

Results

Major depressive disorder (OR=3.2), substance use disorders (OR=1.9) and personality disorders (OR=3.0) occurred more frequently in men reporting symptoms of PTSD than in men who had been under fire who did not report symptoms. With the possible exception of personality disorders, comorbid disorders did not constitute risk factors for PTSD. Comorbid PTSD and RDC disorders were associated with increased help-seeking.

Conclusions

The results suggest similar rates and types of PTSD comorbidity in Israeli war veterans as in veterans in the US assessed in general population studies, and are consistent with shared risk factors for PTSD and comorbid disorders.

Type
Papers
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Bleich, A., Siegel, B., Garb, R., et al (1986) Post-traumatic stress disorder following combat exposure: Clinical features and psychopharmacological treatment. British Journal of Psychiatry, 149, 365369.Google Scholar
Breslau, N. & Davis, G. C. (1987) Posttraumatic stress disorder The stressor criterion. Journal of Nervous and Mental Disease, 175, 255264.Google Scholar
Breslau, N., Davis, G. C., Andreski, P., et al (1991) Traumatic events and postraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48, 216222.Google Scholar
Breslau, N., Davis, G. C., Andreski, P., et al (in press) Epidemiologic findings on PTSD and comorbid disorders in the general population. In Stress, Adversity and Psychopathology (ed. Dohrenwend, B. P.). Washington, DC: APP.Google Scholar
Centers for Disease Control (1988) Health status of Vietnam veterans. Journal of the American Medical Association, 259, 27012724.CrossRefGoogle Scholar
Davidson, J., Swartz, M., Storck, M., et al (1985) A diagnostic and family study of posttraumatic stress disorder. American Journal of Psychiatry, 142, 9093.Google Scholar
Davidson, J., Kudler, H. S., Saunders, W. B., et al (1990) Symptom and comorbidity patterns in World War II and Vietnam veterans with posttraumatic stress disorder. Comprehensive Psychiatry, 31, 162170.CrossRefGoogle ScholarPubMed
Davidson, J., Hughes, D., Blazer, D. G., et al (1991) Post-traumatic stress disorder in the community: An epidemiological study. Psychological Medicine, 21, 713721.Google Scholar
Dohrenwend, B. P., Shrout, P. E., Egri, G., et al (1980) Measures of nonspecific psychological distress and other dimensions of psychopathology in the general population. Archives of General Psychiatry, 17, 12291236.Google Scholar
Dohrenwend, B. P., Levav, I., Shrout, P. E., et al (1992) Socioeconomic status and psychiatric disorders: The causation–selection issue. Science, 255, 946952.CrossRefGoogle ScholarPubMed
Endicott, J. & Spitzer, R. L. (1978) A diagnostic interview: The Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry, 35, 837844.Google Scholar
Escobar, J. I., Randolph, E. T., Puente, G., et al (1983) Posttraumatic stress disorder in Hispanic Vietnam veterans: Clinical phenomenology and sociocultural characteristics. Journal of Nervous and Mental Disease, 171, 585596.Google Scholar
Gibbon, M., MacDonald-Scott, P. & Endicott, J. (1981) Mastering the art of research interviewing: A model training procedure for diagnostic evaluation. Archives of General Psychiatry, 38, 12591262.Google Scholar
Green, B. L., Lindy, J. D. & Grace, M. C. (1985) Posttraumatic stress disorder Toward DSM–IV. Journal of Nervous and Mental Disease, 173, 406411.Google Scholar
Green, B. L., Lindy, J. D., Grace, M. C., et al (1989) Multiple diagnosis in posttraumatic stress disorder: The role of war stressors. Journal of Nervous and Mental Disease, 177, 329335.Google Scholar
Helzer, J. E., Robins, L. N. & McEvoy, L. (1987) Post-traumatic stress disorder in the general population: Findings of the Epidemiologic Catchment Area Survey. New England Journal of Medicine, 317, 16301634.CrossRefGoogle ScholarPubMed
Horowitz, M., Wilner, N. & Alvarez, W. (1979) Impact of Event Scale: A measure of subjective stress. Psychological Medicine, 41, 209218.Google Scholar
Keane, T. M. & Wolff, J. (1990) Comorbidity in post-traumatic stress disorder An analysis of community and clinical studies. Journal of Applied Social Psychology, 20, 17761788.Google Scholar
Kessler, R. C., Sonnega, A., Bromet, E., et al (1995) Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 10481060.Google Scholar
Kulka, R. A., Schlenger, W. E., Fairbank, J. A., et al (1988) National Vietnam Veterans Readjustment Study (NVVRS): Description, Current Status, and Initial PTSD Prevalence Estimates. Final Report. Washington, DC: Veterans Administration.Google Scholar
Lerer, B., Bleich, A., Kotler, M., et al (1987) Posttraumatic stress disorder in Israeli combat veterans: Effect of phenelzine treatment Archives of General Psychiatry, 44, 976981.Google Scholar
Levav, I., Kohn, R., Dohrenwend, B. P., et al (1993) An epidemiological study of mental disorders in a 10-year cohort of young adults in Israel. Psychological Medicine, 23, 691707.CrossRefGoogle Scholar
McFarlane, A. C. & Papay, P. (1992) Multiple diagnoses in posttraumatic stress disorder in the victims of a natural disaster. Journal of Nervous and Mental Disease, 180, 498504.Google Scholar
Mellman, T. A., Randolph, C. A., Brawman-Mintzer, O., et al (1992) Phenomenology and course of psychiatric disorders associated with combat-related posttraumatic stress disorder. American Journal of Psychiatry, 149, 15681574.Google Scholar
Roszell, D. K., McFall, M. E. & Malas, K. L. (1991) Frequency of symptoms and concurrent psychiatric disorder in Vietnam veterans with chronic PTSD. Hospital and Community Psychiatry, 42, 293296.Google Scholar
Schwarzwald, J., Solomon, Z., Wosenberg, M., et al (1987) Validation of the Impact of Event Scale for psychological sequelae of combat Journal of Consulting and Clinical Psychology, 55, 251256.Google Scholar
Shore, J. H., Vollmer, W. M. & Tatum, E. L. (1989) Community patterns of posttraumatic stress disorders. Journal of Nervous and Mental Diseases, 177, 681685.CrossRefGoogle ScholarPubMed
Shrout, P. E., Dohrenwend, B. P. & Levav, I. (1986) A discriminant rule for screening cases of diverse diagnostic types: Preliminary results. Journal of Consulting and Clinical Psychology, 54, 314319.CrossRefGoogle ScholarPubMed
Sierles, F. S., Chen, J., McFarland, R. E., et al (1983) Posttraumatic stress disorder and concurrent psychiatric illness: A preliminary report American Journal of Psychiatry, 140, 11771179.Google Scholar
Sierles, F. S., Chen, J., Messing, M. L., et al (1986) Concurrent psychiatric illness in non-Hispanic outpatients diagnosed as having posttraumatic stress disorder. Journal of Nervous and Mental Disease, 174, 171173.Google Scholar
Solomon, Z. (1989) Characteristic psychiatric symptomatology of post-traumatic stress disorder in veterans: A three year follow-up. Psychological Medicine, 19, 927936.CrossRefGoogle ScholarPubMed
Solomon, Z., Weisenberg, M., Schwarzwald, J., et al (1987) Posttraumatic stress disorder among front line soldiers with combat stress reaction: The 1982 Israeli experience. American Journal of Psychiatry, 144, 448454.Google Scholar
Southwick, S. M., Yehuda, R. & Gillier, E. L. (1993) Personality disorders in treatment-seeking combat veterans with posttraumatic stress disorder. American Journal of Psychiatry, 150, 10201023.Google ScholarPubMed
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