Posttraumatic stress disorder and depression in battle-injured soldiers

Am J Psychiatry. 2006 Oct;163(10):1777-83; quiz 1860. doi: 10.1176/ajp.2006.163.10.1777.


Objective: This study examined rates, predictors, and course of probable posttraumatic stress disorder (PTSD) and depression among seriously injured soldiers during and following hospitalization.

Method: The patients were 613 U.S. soldiers hospitalized following serious combat injury. Standardized screening instruments were administered 1, 4, and 7 months following injury; 243 soldiers completed all three assessments. Cross-sectional and longitudinal analyses of risk factors were performed. PTSD was assessed with the PTSD Checklist; depression was assessed with the Patient Health Questionnaire. Combat exposure, deployment length, and severity of physical problems were also assessed.

Results: At 1 month, 4.2% of the soldiers had probable PTSD and 4.4% had depression; at 4 months, 12.2% had PTSD and 8.9% had depression; at 7 months, 12.0% had PTSD and 9.3% had depression. In the longitudinal cohort, 78.8% of those positive for PTSD or depression at 7 months screened negative for both conditions at 1 month. High levels of physical problems at 1 month were significantly predictive of PTSD (odds ratio=9.1) and depression at 7 months (odds ratio=5.7) when the analysis controlled for demographic variables, combat exposure, and duration of deployment. Physical problem severity at 1 month was also associated with PTSD and depression severity at 7 months after control for 1-month PTSD and depression severity, demographic variables, combat exposure, and deployment length.

Conclusions: Early severity of physical problems was strongly associated with later PTSD or depression. The majority of soldiers with PTSD or depression at 7 months did not meet criteria for either condition at 1 month.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Cohort Studies
  • Combat Disorders / diagnosis*
  • Combat Disorders / epidemiology*
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Female
  • Health Status
  • Hospitalization*
  • Humans
  • Life Change Events
  • Longitudinal Studies
  • Male
  • Military Personnel*
  • Personality Inventory
  • Risk Factors
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Surveys and Questionnaires
  • Trauma Severity Indices
  • United States / epidemiology
  • Veterans
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / psychology