Association Between Post-Traumatic Stress Disorder (PTSD) and Lifetime DSM-5 Psychiatric Disorders among Veterans

"Overall, the prevalence of 6.3% for lifetime DSM-5 PTSD in U.S. veterans is lower than that reported in previous studies of era-specific (18.7% and 52%) (Dohrenwend et al., 2007; Ikin et al., 2010; Jakupcak et al., 2010) veteran cohorts but similar to a national sample of veterans (7.95%; Wisco et al., 2014) using previous diagnostic classifications. In part this may reflect the narrow definition used in the study. However, the lifetime prevalence of PTSD among veterans in this study was very similar to the prevalences of 6.4% and 7.8% reported for DSM-IV PTSD in the general U.S. populations (Kessler et al., 1995; Pietrzak et al., 2011b). Similar to prior studies of veteran and general population samples, prevalence of PTSD was higher among women, and those with PTSD were more likely to be younger, non-white, and have lower income, in addition to reporting more traumatic events (Wisco, et al., 2014; Pietrzak et al., 2011b; Kessler et al., 1995).

"With adjustment for sociodemographic characteristics, PTSD was highly comorbid with all lifetime substance use and aggregate psychiatric disorders assessed in the NESARC-III. These estimates were lower for mood, alcohol use and drug use disorder, higher for nicotine use disorder and similar for anxiety disorders compared to the other recent nationally representative estimates among U.S. veterans (Wisco et al., 2014). Despite changes in diagnostic criteria for PTSD and many other disorders from DSM-IV to DSM-5, they were consistent with previous studies of the general U.S. population (Pietrzak et al., 2011b; Kessler et al., 1995). In models adjusting for only sociodemographic characteristics, PTSD was associated with substance use disorders (AOR=2.1–3.4) and especially mood, anxiety, and personality disorders (AOR=9.6–11.1). After further adjustment for other psychiatric disorders, associations between PTSD and substance use disorders were no longer significant, whereas associations between PTSD and mood, anxiety, and PDs were attenuated. These weaker associations, when adjusting models for psychiatric disorders, suggests shared factors underlying these associations. That the associations between PTSD and mood, anxiety, and PD remained significant, points to possible unique factors contributing to these associations (Agrawal and Lynskey, 2008; Awofala, 2013; Ball, 2008)."