Skip to main content

Post-traumatic stress disorder and depression: An analysis of comorbidity

  • Avi Bleich (a1), Meni Koslowsky (a2), Aliza Dolev (a3) and Bernard Lerer (a4)

We examined psychiatric morbidity following war-related psychic trauma, with a special focus on the depressive comorbidity of post-traumatic stress disorder (PTSD).


Subjects consisted of 60 Israeli veterans who sought psychiatric treatment 4–6 years after having been exposed to war trauma. PTSD and psychiatric comorbidity were diagnosed using the Structured Interview for PTSD and the Schedule for Affective Disorders and Schizophrenia.


Both lifetime (100%) and current (87%) PTSD were the most prevalent disorders. Comorbidity was extensive, with major depressive disorder (MDD) most prevalent (95% lifetime, 50% current), followed by anxiety disorders, minor affective disorders, and alcoholism or drug misuse.


Within post-traumatic psychiatric morbidity of combat origin, PTSD and MDD are the most prevalent disorders. In addition it appears that PTSD, although related to post-traumatic MDD beyond a mere sharing of common symptoms, is of the same time differentiated from it as an independent diagnostic category.

Corresponding author
Dr Mem Koslowsky, Department of Psychology, Bar-llan University, 52900 Ramat-Gan, Israel
Hide All
Bleich, A., Siegal, B., Garb, R., et al (1986) Post-traumatic stress disorder following combat exposure, clinical features, and psychopharmacological treatment. British Journal of Psychiatry, 149, 365369.
Breslau, N., Davis, G. C., Andreski, R, et al (1991) Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48, 216222.
Brom, D., Kleber, R. J. & Witztum, E. (1991) The prevalence of posttraumatic psychopathology in general and clinical population. Israel Journal of Psychiatry, 28, 5363.
Davidson, J., Swartz, M. & Storck, M. (1985) A diagnostic and family study of posttraumatic stress disorder. American Journal of Psychiatry 142, 9093.
Davidson, J., Swartz, M. & Storck, M. Smith, R. D. & Kudler, H. S. (1989) Validity and reliability of the DSM-III criteria for PTSD: experience with a structured interview, Journal of Nervous and Mental Disease, 176, 568572.
Davidson, J., Swartz, M. & Storck, M. Kudler, H., Smith, R., et al (1990) Treatment of post-traumatic stress disorder with amitriptyline and placebo. Archives of General Psychiatry: 47, 259266.
Endicott, J. & Spitzer, R. (1978) A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry, 35, 837844.
Green, B. L., Lindy, J. D., Grace, M. C., et al (1992) Chronic posttraumatic stress disorder and diagnostic comorbidity in a disaster sample, Journal of Nervous and Mental Dsease, 180, 760766.
Health Status of Vietnam Veterans (1988) I: Psychosocial characteristics: the Centers for Disease Control Vietnam experiences study, journal of the American Medical Association, 259, 27012707.
Helzer, J. E., Robins, L. N. & McEroy, L. (1987) Posttraumatic stress disorder in the general population. New England Journal of Medicine, 317, 16301634.
Jordan, B. K., Schlenger, W. E., Hough, R., et al (1991) Life-time and current prevalence of specific psychiatric disorders among Vietnam veterans and controls. Archives of General Psychiatry 48, 207215.
Kessler, R. C., Sonnega, A., Bromet, E., et al (1995) Post-traumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry 52, 10481060.
Kosten, T. R., Frank, J. B., Dan, E., et al (1991) Pharmacotherapy for posttraumatic stress disorder using phenelzine or imipramine. Journal of Nervous and Mental Disease, 179, 366370.
Lerer, B., Bleich, A., Kotler, M., et al (1987) Posttraumatic stress disorders in Israeli combat veterans: effects of phenelzine treatment. Archives of General Psychiatry 44, 976981.
McFariana, A. C. & Papay, R (1992) Multiple diagnoses in posttraumatic stress disorder in the victims of a natural disaster, Journal of Nervous and Mental Disease, 180, 498504.
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.
Sierles, F. S., Chen, J. J., McFarland, R. E., et al (1983) Posttraumatic stress disorder and concurrent psychiatric illness: a preliminary report. American Journal of Psychiatry 140, 11771179.
Solomon, Z. (1989) Untreated combat-related PTSD - why some Israeli veterans do not seek help. Israel Journal of Psychiatry 24, 111123.
Solomon, Z. Bieich, A., Koslowsky, M., et al (1991) Post-traumatic stress disorder: issues of comorbidity, Journal of Psychiatric Research, 25, 8994.
Van der Kolk, B. (1994) The body keeps the score: memory and evolving psychobiology of PTSD. Harvard Review of Psychiatry, 1, 253265.
Watson, C. G., Kucala, T., Manifold, V., et al (1988) Differences between PTSD patients with delayed and undelayed onset, Journal of Nervous and Mental Disease, 176, 568572.
Yehuda, R., Southwick, S. M., Krystal, J. H., et al (1993) Enhanced suppression of cortisol following dexamethasone administration in posttraumatic stress disorder. American Journal of Psychiatry 150, 8386.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Post-traumatic stress disorder and depression: An analysis of comorbidity

  • Avi Bleich (a1), Meni Koslowsky (a2), Aliza Dolev (a3) and Bernard Lerer (a4)
Submit a response


No eLetters have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *