Psy-Q: Should clinicians be concerned about mortality when a patient presents with comorbid PTSD and depression?

Andrea Roberts, PhD

Andrea Roberts, PhD

Answer

Yes, particularly if the patient is a woman.  Women who have high PTSD symptoms and depression can have a nearly 4-fold risk of death compared to women with no trauma or depression, according to a recent study led by Andrea L. Roberts, PhD, a senior research scientist at Harvard’s T.H. Chan School of Public Health.

The study, “Association of Posttraumatic Stress and Depressive Symptoms With Mortality in Women,” looked at data gathered from the Nurses’ Health Study II – which included following 51,602 women for up to 9 years. The authors found that the risk of death from cardiovascular disease, diabetes, injury, suicide, and other causes was significantly increased in women who had diagnoses of both PTSD and depression compared to those who did not.

Dr. Roberts’ team further noted that the lifetime prevalence of PTSD in women is twice that of men and that depression (which often co-occurs with PTSD) is twice as prevalent in women than men. Here, she discusses the research in more detail with Psycom Pro.

Psycom Pro: What is important for clinicians to understand about these results? What steps can they take to better help their patients?

Dr. Roberts: Clinicians should be aware that mental health is intertwined with physical health and is foundational for overall health. Just as physicians are concerned about smoking, seat-belt wearing, weight, and diet, they need to ask about trauma exposure and mental well-being. Patients would benefit from physicians working to destigmatize mental illness and to encourage open discussion of mental health. [Primary care and referring] physicians should familiarize themselves with available treatments for mental health in their area.

Psycom Pro: Your team reported that most research about PTSD and increased risk of death is done on male veterans and that yours is one of the first studies to focus on co-occurring PTSD and depression in women. Did your findings surprise you?

Dr. Roberts: We were surprised by how much greater risk of mortality was associated with PTSD and depression among our cohort of middle-aged health professionals.

Psycom Pro: What is your next step in this line of research?

Dr. Roberts: We need to better understand what causes people with depression and PTSD to be at greater risk of mortality. From our study, we know that they had greater risk of death across a wide spectrum of diseases – including CV disease, diabetes, and unintentional injury. In addition, we need to determine whether effective treatment for depression and PTSD reduces risk of illness and death in women with mental health challenges.

 

Last Updated: Jan 8, 2021