A comparison of physical comorbidities in patients with posttraumatic stress disorder developed after a terrorist attack or other traumatic event.

No study investigated whether the presence of specific medical comorbidities is associated with the type of traumatic event, in particular with terrorist attack (TA). In a group of subjects with posttraumatic stress disorder (PTSD), the current study investigated the association between the types of traumatic event (TA vs. other traumatic event [OTE]) and medical comorbidities, controlling for sex and PTSD duration. The Mini International Neuropsychiatric Interview, the Clinician-Administered PTSD Scale, and the Davidson Trauma Scale were administered to 84 subjects diagnosed with PTSD. Thirty-nine were victims of TA and 45 victims of OTE. TA was associated with higher prevalence of neoplasms (ß = 2.60, p = 0.02). Females were more protected than males from circulatory system comorbidities (ß = 1.47, p = 0.04), while PTSD duration was associated with higher prevalence of such comorbidities (ß = 0.005, p = 0.01). Females showed a higher prevalence of neoplasms than males (ß = 2.50, p = 0.02). Female sex was protective against metabolic syndrome (ß = -1.79, p = 0.02). Patients with PTSD due to TA and female patients should be considered for their higher prevalence of neoplasms, while male patients and those with higher symptom duration should be monitored for circulatory disease and metabolic syndrome. Symptom duration might be associated with circulatory and metabolic disease. Implications for tailored and timely psychopharmacological and psychotherapeutic intervention for PTSD are discussed focusing on these specific medical comorbidities.

The Effects of Terrorist Attacks on Symptom Clusters of PTSD: a Comparison with Victims of Other Traumatic Events.

In the Post-Traumatic Stress Disorder (PTSD) literature, no study assessed differences in symptom clusters among victims of terrorist attacks (TA) as compared with victims of other traumatic events. Due to the intentional nature of the harm infliction, TA may be expected to produce more severe symptoms, particularly avoidance, since this cluster was found to be a severity marker and a maintenance factor of the disorder. As several patients delay treatment-seeking, duration of untreated illness (DUI) is another problem potentially influencing PTSD severity. The current study explored differences in PTSD symptom clusters as a function of the traumatic event type (TA compared with other events), DUI, and sex. One hundred-eight patients with primary PTSD were administered The Clinician Administered PTSD Scale. Mean DUI was approximately 12 years, irrespective of the event type. Patients who had experienced TA had significantly more severe Avoidance/Numbing symptoms and general PTSD severity than those who had experienced other events. No significant effects emerged for DUI and sex on all clusters. Timely recognition and intervention on PTSD may include community psychoeducation programs about its symptoms. Tailored intervention on TA-related PTSD may focus on Avoidance/Numbing by including medication and psychotherapeutic approaches for this symptom cluster.

Convergence between clinician-rated and patient-reported PTSD symptoms in a specialized outpatient service: The moderator role of gender.

PURPOSE: Posttraumatic stress disorder (PTSD) includes different symptoms: re-experiencing, avoidance of reminders and numbing, and hyperarousal. Although questionnaires are widely used, clinician-administered interviews provide a more comprehensive exploration of symptoms. Few studies examined the convergence between clinician-rated and patient-reported general severity and symptoms, with mixed findings. We explored the association between clinician-rated and patient-reported general severity and symptoms and the moderator role of gender in PTSD patients referred to a specialized outpatient service. DESIGN AND METHODS: The Clinician-Administered PTSD Scale and Davidson Trauma Scale were administered to 56 patients. FINDINGS: Patients classified by clinicians as with higher avoidance/numbing symptoms and women classified with higher hyperarousal symptoms reported higher general severity. PRACTICE IMPLICATIONS: The assessment of the patients reporting high severity should focus on hyperarousal, particularly for women.

Post-traumatic stress disorder in Italy: a comprehensive evaluation of all the ICD comorbidities and gender-related differences.

OBJECTIVES: The association between post-traumatic stress disorder (PTSD) and medical comorbidities is controversial since most studies focused on specific comorbidity and victim types. In Italy, data on this issue are scarce. A comprehensive evaluation of all the ICD medical categories co-occurring in PTSD may orient assessment and treatment during clinical and forensic practice. This is the first study evaluating all the ICD physical comorbidities and gender-related differences in Italian PTSD patients. Eighty-four PTSD patients (36 females, 48 males) were included. The Clinician-Administered PTSD Scale, Mini International Neuropsychiatric Interview and Davidson Trauma Scale were administered. RESULTS: Most patients had a PTSD consequent to an accident and half of them presented extreme symptom severity. No gender differences emerged on symptom severity/duration and age at the event. Metabolic (39.29%), circulatory (20.24%) and musculoskeletal systems/connective tissue diseases (17.86%) were the most frequent comorbidities. Metabolic/circulatory diseases were more frequent among males (p = 0.019 and p = 0.027, respectively) while females more frequently showed neoplasms (p = 0.039). Physical comorbidities represent a serious complication in PTSD patients and are more prevalent than in the Italian population. While gender is not associated with symptom presentation, it seems to play a key role in specific comorbidities including metabolic, circulatory and neoplastic diseases.