Risk-factors and comorbidity of ICD-11 PTSD and Complex PTSD: Findings from a trauma-exposed population based sample of adults in the United Kingdom

Thanos Karatzias, Philip Hyland, Aoife Bradley, Marylene Cloitre, Neil P. Roberts, Jonathan I Bisson, M Shevlin

Research output: Contribution to journalArticle

Abstract

Background: Following the recently published 11th version of the WHO International Classification of Diseases (ICD-11), we sought to examine the risk factors and comorbidities associated with posttraumatic stress disorder (PTSD) and Complex PTSD (CPTSD). Method: Cross-sectional and retrospective design. The sample consisted of 1051 trauma-exposed participants from a nationally representative panel of the UK adult population. Results: 5.3% (95% CI = 4.0%-6.7%) met the diagnostic criteria for PTSD and 12.9% (95% CI = 10.9%-15.0%) for CPTSD. Diagnosis of PTSD was independently associated with being female, being in a relationship, and the recency of traumatic exposure. CPTSD was independently associated with younger age, interpersonal trauma in childhood, and interpersonal trauma in adulthood. Growing up in an urban environment was associated with diagnosis of PTSD and CPTSD. High rates of physical and mental health comorbidity were observed for PTSD and CPTSD. Those with CPTSD were more likely to endorse symptoms reflecting Major Depressive Disorder (OR = 21.85, 95 CI = 12.51 – 38.04) and Generalized Anxiety Disorder (OR = 24.63, 95 CI = 14.77 – 41.07). Presence of PTSD (OR = 3.13, 95 CI = 1.81 – 5.41) and CPTSD (OR = 3.43, 95 CI = 2.37 – 4.70) increased the likelihood of suicidality by more than three times. Nearly half the participants with PTSD and CPTSD reported the presence of a chronic illness. Conclusions: CPTSD is a more common, co-morbid, debilitating condition compared PTSD. Further research is now required to identify effective interventions for its treatment.
LanguageEnglish
JournalDepression and Anxiety
Publication statusAccepted/In press - 25 May 2019

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Post-Traumatic Stress Disorders
Comorbidity
Wounds and Injuries
Population
United Kingdom
Major Depressive Disorder
International Classification of Diseases
Anxiety Disorders

Keywords

  • ICD 11 PTSD,
  • comorbidities
  • CPTSD

Cite this

Karatzias, Thanos ; Hyland, Philip ; Bradley, Aoife ; Cloitre, Marylene ; Roberts, Neil P. ; Bisson, Jonathan I ; Shevlin, M. / Risk-factors and comorbidity of ICD-11 PTSD and Complex PTSD: Findings from a trauma-exposed population based sample of adults in the United Kingdom. In: Depression and Anxiety. 2019.
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Risk-factors and comorbidity of ICD-11 PTSD and Complex PTSD: Findings from a trauma-exposed population based sample of adults in the United Kingdom. / Karatzias, Thanos; Hyland, Philip; Bradley, Aoife ; Cloitre, Marylene; Roberts, Neil P.; Bisson, Jonathan I; Shevlin, M.

In: Depression and Anxiety, 25.05.2019.

Research output: Contribution to journalArticle

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T1 - Risk-factors and comorbidity of ICD-11 PTSD and Complex PTSD: Findings from a trauma-exposed population based sample of adults in the United Kingdom

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AU - Bradley, Aoife

AU - Cloitre, Marylene

AU - Roberts, Neil P.

AU - Bisson, Jonathan I

AU - Shevlin, M

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N2 - Background: Following the recently published 11th version of the WHO International Classification of Diseases (ICD-11), we sought to examine the risk factors and comorbidities associated with posttraumatic stress disorder (PTSD) and Complex PTSD (CPTSD). Method: Cross-sectional and retrospective design. The sample consisted of 1051 trauma-exposed participants from a nationally representative panel of the UK adult population. Results: 5.3% (95% CI = 4.0%-6.7%) met the diagnostic criteria for PTSD and 12.9% (95% CI = 10.9%-15.0%) for CPTSD. Diagnosis of PTSD was independently associated with being female, being in a relationship, and the recency of traumatic exposure. CPTSD was independently associated with younger age, interpersonal trauma in childhood, and interpersonal trauma in adulthood. Growing up in an urban environment was associated with diagnosis of PTSD and CPTSD. High rates of physical and mental health comorbidity were observed for PTSD and CPTSD. Those with CPTSD were more likely to endorse symptoms reflecting Major Depressive Disorder (OR = 21.85, 95 CI = 12.51 – 38.04) and Generalized Anxiety Disorder (OR = 24.63, 95 CI = 14.77 – 41.07). Presence of PTSD (OR = 3.13, 95 CI = 1.81 – 5.41) and CPTSD (OR = 3.43, 95 CI = 2.37 – 4.70) increased the likelihood of suicidality by more than three times. Nearly half the participants with PTSD and CPTSD reported the presence of a chronic illness. Conclusions: CPTSD is a more common, co-morbid, debilitating condition compared PTSD. Further research is now required to identify effective interventions for its treatment.

AB - Background: Following the recently published 11th version of the WHO International Classification of Diseases (ICD-11), we sought to examine the risk factors and comorbidities associated with posttraumatic stress disorder (PTSD) and Complex PTSD (CPTSD). Method: Cross-sectional and retrospective design. The sample consisted of 1051 trauma-exposed participants from a nationally representative panel of the UK adult population. Results: 5.3% (95% CI = 4.0%-6.7%) met the diagnostic criteria for PTSD and 12.9% (95% CI = 10.9%-15.0%) for CPTSD. Diagnosis of PTSD was independently associated with being female, being in a relationship, and the recency of traumatic exposure. CPTSD was independently associated with younger age, interpersonal trauma in childhood, and interpersonal trauma in adulthood. Growing up in an urban environment was associated with diagnosis of PTSD and CPTSD. High rates of physical and mental health comorbidity were observed for PTSD and CPTSD. Those with CPTSD were more likely to endorse symptoms reflecting Major Depressive Disorder (OR = 21.85, 95 CI = 12.51 – 38.04) and Generalized Anxiety Disorder (OR = 24.63, 95 CI = 14.77 – 41.07). Presence of PTSD (OR = 3.13, 95 CI = 1.81 – 5.41) and CPTSD (OR = 3.43, 95 CI = 2.37 – 4.70) increased the likelihood of suicidality by more than three times. Nearly half the participants with PTSD and CPTSD reported the presence of a chronic illness. Conclusions: CPTSD is a more common, co-morbid, debilitating condition compared PTSD. Further research is now required to identify effective interventions for its treatment.

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KW - comorbidities

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JF - Depression and Anxiety

SN - 1091-4269

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