PTSD More Detrimental to One’s Health Than Any Coexisting Mental Illness
Recent findings from a team of Brazilian researchers indicate that PTSD plays a primary role in reducing an affected person’s health-related quality of life, even when that individual has other significant, coexisting problems with mental illness.
Some people affected by post-traumatic stress disorder (PTSD) also have serious problems with other mental health issues classified as mood disorders or anxiety disorders. In a study published in January 2015 in the journal Comprehensive Psychiatry, researchers from three Brazilian universities assessed the impact that PTSD and coexisting mental illness have on health-related quality of life. These researchers concluded that PTSD is a critical factor in reducing quality of life, irrespective of the negative influences of other mental health issues.
Post-traumatic stress disorder is the most widely known condition in a group of diagnosable mental health problems that the American Psychiatric Association (APA) defines as trauma- and stressor-related disorders. In the past, PTSD was included with another group of problems, known as anxiety disorders. However, the APA changed this designation in 2013 in order to highlight the role of emotional trauma and stress in the onset of mental illness. In order to qualify for a PTSD diagnosis, an individual must have been directly or indirectly exposed to some sort of traumatic event or situation. Thirty days or more after this exposure, he or she must exhibit symptoms of a serious and ongoing dysfunctional reaction to trauma. Examples of the symptoms required for a diagnosis include nightmares, flashbacks or other signs of an involuntary reliving of prior traumatic experiences; recurring attempts to strictly avoid any reminders of trauma exposure; a substantial increase in negative or “down” emotions or thought processes; and an unusually jumpy, irritable, reckless or aggressive mental state.
When all potential sources of trauma are taken into consideration, men have a somewhat higher overall level of exposure than women. About 20 percent of all women who live through traumatic experiences will develop post-traumatic stress disorder, the U.S. Department of Veterans Affairs’ National Center for PTSD reports. Among men who live through traumatic experiences, the PTSD rate is roughly 8 percent.
Coexisting Mental Illnesses
Several types of additional mental illnesses appear with some regularity in people affected by PTSD. Examples of specific problems include various types of substance use disorder (drug or alcohol abuse/addiction), major depression, obsessive-compulsive disorder, psychosis and anxiety disorders such as generalized anxiety disorder, social anxiety disorder and panic disorder. In many cases, additional mental illness in a person with PTSD has a comorbid effect. Essentially, this means that the combination of two or more mental health problems has a considerably worse effect on an individual’s health and well-being than any of the problems would produce on their own.
Impact on Quality of Life
In the study published in Comprehensive Psychiatry, researchers from Brazil’s Federal University of Rio de Janeiro, Fluminense Federal University and National School of Public Health used a small-scale project involving 65 adults to estimate the impact that PTSD and any comorbid mental illnesses have on a given individual’s health-related quality of life. All of these adults had a main diagnosis of PTSD and were survivors of violence-related traumatic experiences. Additional mental health problems found in the study participants included mood disorders (depression or bipolar disorder), anxiety disorders and indications of psychosis. Each participant underwent assessments for aspects of health and well-being that included day-to-day physical function, day-to-day mental function, day-to-day emotional control and the ability to function in social environments.
After completing their assessments, the researchers concluded that the main predictor of declining health-related quality of life in a person with PTSD is the severity of his or her PTSD symptoms, even if he or she clearly has additional problems with comorbid mental illness. This finding applies to all of the illnesses under consideration, including depression, obsessive-compulsive disorder and several anxiety disorders. The researchers additionally concluded that the single quality of life aspect most significantly impacted by the severity of PTSD is the ability to function well in social environments. They also concluded that, in a person with post-traumatic stress disorder, depression symptoms account for much of the decline in health-related quality of life not attributable to PTSD.
Based on their findings, the study’s authors believe that PTSD treatment programs should focus much of their efforts on improving their clients’/patients’ health-related quality of life.