Citation

Jacobson MH, Norman C, Nguyen A, Brackbill RM. J. Affect. Disord. 2018; 229: 483-490.

Affiliation

World Trade Center Health Registry, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY 10013, United States.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.jad.2017.12.105

PMID

29334643

Abstract

BACKGROUND: Exposure to the September 11, 2001 (9/11) terrorist attacks has been found to be associated with posttraumatic stress disorder (PTSD) and comorbid PTSD and depression up to 10-11 years post-disaster. However, little is known about the longitudinal predictors of mental health conditions over time.

METHODS: We examined longitudinal determinants of depression within strata of PTSD among 21,258 enrollees of the World Trade Center Health Registry who completed four questionnaires over 14 years of follow-up (Wave 1 in 2003-04; Wave 2 in 2005-06; Wave 3 in 2011-12; and Wave 4 in 2015-16). PTSD status was measured using the PTSD checklist on all four waves and defined as a score of ≥ 44; depression was assessed using the 8-item Patient Health Questionnaire at Waves 3 and 4 and defined as a score of ≥ 10.

RESULTS: Across Waves 3 and 4, 18.6% experienced depression, and it was more common among those who ever had PTSD (56.1%) compared with those who had not (5.6%). Across PTSD strata, predictors of depression included low income, unemployment, low social integration and support, post-9/11 traumatic life events, and chronic physical illness. These factors also decreased the likelihood of recovering from depression. LIMITATIONS: Depression symptoms were not measured at Waves 1 and 2; data was self-reported.

CONCLUSIONS: These findings highlight the substantial burden of depression in a trauma-exposed population 14-15 years post-disaster, especially among those with PTSD. Similar life stressors predicted the course of depression among those with and without PTSD which may inform public health and clinical interventions.

Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Language: en

Keywords

Comorbidity; Depression; Disasters; Posttraumatic stress disorder; September 11 terrorist attacks