Leo Sher, M.D.

A research report, “Is suicidal behavior in mood disorders altered by comorbid PTSD?” has been published in Crisis: The Journal of Crisis Intervention and Suicide Prevention online ahead of print (1). The authors compared suicidal behavior among veterans who have comorbid mood disorder and posttraumatic stress disorder (PTSD) with suicidal behavior in veterans who have a mood disorder alone.

The study examined individuals who reported at least some intent to die when engaging in the self-injurious behavior. Participants were 57 U.S. military veterans enrolled in VA health care in a large, urban, academic medical center.

Both groups had comparable levels of intent to die. Veterans diagnosed with comorbid mood disorder and PTSD were more likely than those with a mood disorder alone to report that the self-injurious behavior was impulsive and to be under the influence of substances at the time of self-injury. The fact that diagnoses were attained through patients’ hospital discharge summaries rather than through formal diagnostic interviews was one of the limitations of this study.

The results of this study may be consistent with a concept of posttraumatic mood disorder proposed by me 13 years ago (2,3). Studies suggest that patients suffering from comorbid PTSD and depression differ clinically and biologically from individuals with PTSD alone or depression alone. I proposed that it is possible that some or all individuals diagnosed with comorbid PTSD and depression have a separate psychobiological condition that can be termed “post-traumatic mood disorder.”

References

1. Lento RM, Carson-Wong A, Green JD, AhnAllen CG, Kleespies PM. Is suicidal behavior in mood disorders altered by comorbid PTSD? Crisis. 2018 Jul 27:1-5. doi: 10.1027/0227-5910/a000532. [Epub ahead of print]

2. Sher L. The concept of post-traumatic mood disorder. Med Hypotheses. 2005;65(2):205-10.

3. Sher L. Posttraumatic mood disorder: a new concept. Can J Psychiatry. 2005 Feb;50(2):127-8.