Abstract
A Structured Clinical Interview for the DSM-IV (SCID) and psychological testing were administered to 260 combat veterans in order to investigate the relationship between symptoms of post-traumatic stress disorder (PTSD) and melancholic features of depression. Sixty-seven percent of PTSD patients experiencing comorbid major depression acknowledged symptoms indicative of a melancholic-depression subtype. Correlational and regression analyses show that the presence of melancholic features is related to severity of emotional-numbing experienced by the PTSD patients. These results suggest PTSD patients are likely to experience depressive episodes phenomenologically similar to melancholic-depression. It is likely that acknowledgment of melancholic symptoms is due to (a) the inclusion of guilt as a melancholic feature, and (b) the similarities between emotional numbing symptoms and other melancholic features.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB: Posttraumatic stress disorder in the national comorbidity survey. Arch Gen Psychiatry 1995; 52:1048–1060
Orsillo SM, Weathers FW, Litz BT, Steinberg HR, Huska JA, Keane TM: Current and lifetime psychiatric disorders among veterans with warzone-related posttraumatic stress disorder. J Nerv Ment Dis 1996; 184(5):307–313
Halbreich U, Olympia J, Glogowski J, Carson S, Axelrod S, Yeh CM: The importance of past psychological trauma and pathophysiologic process as determinants of current biologic abnormalities. Arch Gen Psychiatry 1988; 45:293–294
Kosten TR, Wahby, V, Giller E, et al.: The dexamethasone suppression test and TRH stimulation test in posttraumatic stress disorder. Biol Psychiatry 1990; 28(8):665–672
Yehuda R, Southwick SM, Krystal JH, Bremner D, Charney DS, Mason JW: Enhanced suppression of cortisol following dexamethasone administration in posttraumatic stress disorder. Am J Psychiatry 1993; 50(1):83–86
Birkheimer LJ, DeVane CL, Muniz CE: Post-traumatic stress disorder: Characteristics and pharmacological response in the veteran population. Comp Psychiatry 1985; 26:304–310
Frank JB, Kosten TR, Giller EL Jr, et al.: A randomized clinical trial of phenelzine and imipramine for posttraumatic stress disorder. Am J Psychiatry 1988; 145:1289–1291.
Reist C, Kauffman CD, Jaier RJ, et al.: A controlled trial of desipramine in 18 men with posttraumatic stress disorder. Am J Psychiatry 1989; 146:513–516
Southwick SM, Yehuda R, Giller EL, et al.: Characterization of depression in war-related posttraumatic stress disorder. Am J Psychiatry 1991; 148(2):179–183
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Association; 1994
Horowitz MJ: Stress-response syndromes: A review of posttraumatic stress and adjustment disorders. In: Wilson JP, Raphael B, eds. International Handbook of Traumatic Stress Syndromes. New York: Plenum Press; 1993:49–60
Friedman MJ, Yehuda, R: Post-traumatic stress disorder and comorbidity: Psychological approaches to differential diagnosis. In: Friedman MJ, Charney DS, Deutch AY, eds. Biological and Clinical Consequences of Stress: From Normal Adaptation to PTSD. Philadelphia: Lippincott-Raven; 1995:429–445
First MB, Spitzer RL, Gibbon M, Williams JBW: Structured Clinical Interview for Axis I DSM-IV Disorders—Patient Edition (SCID-I/P, Version 2.0). New York: Biometrics Research Department, New York State Psychiatric Institute; 1994
Beck AT, Steer RA, Garbin MG: Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev 1988; 8:77–100
Keane TM, Fairbank JA, Caddel JM, et al.: Clinical evaluation of a measure to assess combat exposure. J Consult Clin Psychol 1989; 1:53–55
Spielberger CD, Gorsuch RL, Lushene R, et al.: Manual for the State-Trait Anxiety Inventory (Form Y). Palo Alto, CA: Consulting Psychologists Press; 1983
Butcher JN, Dahlstrom WG, Graham JR, et al.: Minnesota Multiphasic Personality Inventory-2: Manual for Administration and Scoring. Minneapolis, MN: University of Minnesota Press; 1989.
Keane TM, Caddell JM, Taylor KL: Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: Three studies in reliability and validity. J Consult Clin Psych 1988; 56:85–90
Lafer B, Nierenber AA, Rosenbaum JF, Fava M: Outpatients with DSM-III-R versus DSM-IV melancholic depression. Comp Psychiatry 1996; 37:37–39
Glover H: Survival guilt and the Vietnam veteran: J Nerv Ment Dis 1988; 72(7):393–397
Rush AJ, Weissenburger JE: Melancholic symptom features and DSM-IV. Am J Psychiatry 1994; 151:489–498
Friedman MJ: Interrelationships between biological mechanisms and pharmacotherapy of posttraumatic stress disorder. In Wolfe ME, Mosnaim AD, eds. Post-traumatic Stress Disorder: Etiology, Phenomenology, and Treatment. Washington, DC: American Psychiatric Press; 1990:204–225
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Constans, J.I., Lenhoff, K. & McCarthy, M. Depression Subtyping in PTSD Patients. Ann Clin Psychiatry 9, 235–240 (1997). https://doi.org/10.1023/A:1022304410404
Issue Date:
DOI: https://doi.org/10.1023/A:1022304410404