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Posttraumatic Stress Disorder and Psychiatric Comorbidity among Adolescent Earthquake Survivors: a Longitudinal Cohort Study

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Abstract

Although posttraumatic stress disorder (PTSD) is highly comorbid with psychiatric disorders, little longitudinal research has been conducted to determine the potentially causal links. This study aimed to investigate the prevalence and comorbidity patterns of posttraumatic stress disorder symptoms and psychiatric symptoms among adolescents exposed to the 2008 Wenchuan earthquake in China and to examine the bidirectional prospective associations between PTSD symptoms and other psychiatric symptoms. A sample of 1573 adolescent survivors (45.8% male; mean age at initial survey was 15.0 years, SD = 1.3) completed a battery of standardized measures assessing symptoms of PTSD, depression, panic disorder, generalized anxiety disorder (GAD), separation anxiety disorder (SAD), social phobia, conduct disorder, and attention deficit hyperactivity disorder at 6 and 18 months post-earthquake. Among participants with PTSD symptoms, 91.9 and 94.0% had at least one comorbid psychiatric disorder at 6 and 18 months post-earthquake, respectively; however, among those without PTSD symptoms, 54.3 and 50.4% had at least one psychiatric disorder. PTSD symptoms were more likely to co-occur with subtypes of anxiety or depression symptoms than with behavior problems. Participants who were screened as having PTSD comorbid with depression or SAD at 6 months were less likely to recover from PTSD over time. Longitudinal analyses showed that symptoms of depression, GAD and SAD predicted increases in PTSD symptoms. In turn, PTSD symptoms predicted increases in GAD and panic disorder symptoms. Overall, our results support causal hypotheses of PTSD comorbidity. Specific multi-modal assessments and treatments targeting to both PTSD and its comorbidity disorders are warranted.

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Authors and Affiliations

  1. School of Psychology, South China Normal University, Guangzhou, Guangdong, People’s Republic of China

    Fulei Geng, Ya Zhou, Yingxin Liang, Xin Zheng, Yuanyuan Li, Xiaoyan Chen & Fang Fan

  2. Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, People’s Republic of China

    Fulei Geng, Ya Zhou, Yingxin Liang, Xin Zheng, Yuanyuan Li, Xiaoyan Chen & Fang Fan

  3. Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, Guangdong, People’s Republic of China

    Fulei Geng, Ya Zhou, Yingxin Liang, Xin Zheng, Yuanyuan Li, Xiaoyan Chen & Fang Fan

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  1. Fulei Geng
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  2. Ya Zhou
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  3. Yingxin Liang
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  4. Xin Zheng
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  5. Yuanyuan Li
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  6. Xiaoyan Chen
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  7. Fang Fan
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Correspondence to Fang Fan.

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Funding

The present study was funded by National Natural Science Foundation of China (grant numbers: 31271096, 31671165); Research on the Processes and Repair of Psychological Trauma in Youth, Project of Key Institute of Humanities and Social Sciences, MOE (grant number: 16JJD190001); Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme, GDUPS (2016); China Postdoctoral Science Foundation (grant numbers: 2016 M590793, 2017 T100638).

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The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the Human Research Ethics Committee of South China Normal University and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Geng, F., Zhou, Y., Liang, Y. et al. Posttraumatic Stress Disorder and Psychiatric Comorbidity among Adolescent Earthquake Survivors: a Longitudinal Cohort Study. J Abnorm Child Psychol 47, 671–681 (2019). https://doi.org/10.1007/s10802-018-0462-2

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