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The British Journal of Psychiatry (2004) 184: 247-250
© 2004 The Royal College of Psychiatrists

Post-traumatic stress and disability

Leigh A. Neal, MD, MRCPsych, MRCGP, DRCOG and Gillian Green, RMN, DipN(Comm), BSc(Hons)

Defence Medical Services Psychological Injuries Unit, Duchess of Kent Psychiatric Hospital

Mark A. Turner, MRCP, MRCPsych

Duchess of Kent Psychiatric Hospital, Catterick Garrison, North Yorkshire, UK

Correspondence: Dr Leigh A. Neal, Bristol Priory Hospital, Heath House Lane, Stapleton, Bristol BS16 1EQ, UK. Tel: 0117 9525255; e-mail: info{at}mhra-uk.com

Declaration of interest None.

Background Post-traumatic stress is thought to account for significant disability. It is also known to be highly comorbid with other psychiatric conditions such as depression and alcohol dependence.

Aims To determine the relationship between post-traumatic stress, depression, alcohol dependence and disability.

Method Seventy armed services personnel were assessed for DSM–IV diagnoses of post-traumatic stress disorder, major depressive disorder and alcohol dependence, and with continuous measures of symptoms of post-traumatic stress, depression and alcohol dependence following a traumatic event. These variables, as predictors of disability (using the Sheehan Disability Scale), were analysed using multivariate analysis of variance, analysis of covariance and multiple regression backward elimination models.

Results No significant interaction was found for the diagnostic variables even after controlling for the continuous symptom measures. In the regression models, symptoms of depression were a significant predictor of total disability (R2=0.39). Symptoms of alcohol dependence and post-traumatic stress did not significantly predict disability.

Conclusions Since post-traumatic stress was not found to be associated with disability, its clinical importance may be questionable.




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