Friday, April 2, 2010

PTSD and mood disorders

Steven C. Dilsaver, MD, Comprehensive Doctors Medical Group, Inc., Arcadia, CA

Major depressive disorder (MDD) and bipolar spectrum disorders are associated with some symptoms of—and fully defined—posttraumatic stress disorder (PTSD). Many traumatic experiences can lead to this comorbidity, the most common being exposure to or witnessing combat for men and rape and sexual molestation for women.Trauma has major prognostic and treatment implications for affectively ill patients, including those whose symptoms do not meet PTSD’s full diagnostic criteria.

This article aims to help clinicians by:
  • presenting evidence characterizing the overlap between affective disorders and PTSD
  • reviewing evidence that the bipolar spectrum may be broader than generally thought, an insight that affects PTSD treatment
  • making a case for routine PTSD screening for all patients with affective illnesses
  • recommending PTSD treatments tailored to the patient’s comorbid affective disorder
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