Longitudinal determinants of depression among World Trade Center Health Registry enrollees, 14-15 years after the 9/11 attacks

JOURNAL OF AFFECTIVE DISORDERS

卷:229

Article

Jacobson, Melanie H.¹  Norman, Christina²  Nguyen, Angela¹  Brackbill, Robert M.¹ 

[1] New York City Dept Hlth & Mental Hyg, World Trade Ctr Hlth Registry, Div Epidemiol, New York, NY 10013 USA

[2] New York City Dept Hlth & Mental Hyg, Div Mental Hyg, Queens, NY 11101 USA

关键词: Depression;    Posttraumatic stress disorder;    Comorbidity;    September 11 terrorist attacks;    Disasters;   

DOI  :  10.1016/j.jad.2017.12.105

来源: Elsevier

【 摘 要 】

Background: Exposure to the September 11, 2001 (9/11) terrorist attacks has been found to be associated with posttraumatic stress disorder (PTSD) and comorbid PTSD and depression up to 10-11 years post-disaster. However, little is known about the longitudinal predictors of mental health conditions over time. Methods: We examined longitudinal determinants of depression within strata of PTSD among 21,258 enrollees of the World Trade Center Health Registry who completed four questionnaires over 14 years of follow-up (Wave 1 in 2003-04; Wave 2 in 2005-06; Wave 3 in 2011-12; and Wave 4 in 2015-16). PTSD status was measured using the PTSD checklist on all four waves and defined as a score of >= 44; depression was assessed using the 8-item Patient Health Questionnaire at Waves 3 and 4 and defined as a score of >= 10. Results: Across Waves 3 and 4, 18.6% experienced depression, and it was more common among those who ever had PTSD (56.1%) compared with those who had not (5.6%). Across PTSD strata, predictors of depression included low income, unemployment, low social integration and support, post-9/11 traumatic life events, and chronic physical illness. These factors also decreased the likelihood of recovering from depression. Limitations: Depression symptoms were not measured at Waves 1 and 2; data was self-reported. Conclusions: These findings highlight the substantial burden of depression in a trauma-exposed population 14-15 years post-disaster, especially among those with PTSD. Similar life stressors predicted the course of depression among those with and without PTSD which may inform public health and clinical interventions.

【 授权许可】

Free