Psychological comorbidity, the co-occurrence of mental health disorders, is more often the rule than the exception among individuals with posttraumatic stress disorder (PTSD). Research shows that prevalence estimates for specific psychological disorders differ by gender; however, little is known about whether these patterns persist in the presence of a comorbid PTSD diagnosis. This study examined gender differences in prevalence estimates for conditions comorbid with PTSD using medical records for 523,626 active duty U.S. Sailors and Marines who entered the military over an 8-year period. Using chi-square tests of independence, we detected statistically significant gender differences for specific comorbid conditions in the subsample of 9,447 service members with a PTSD diagnosis. Women were more likely than men to have PTSD with comorbid adjustment, OR = 1.35; depressive, OR = 1.71; and generalized anxiety or other anxiety disorders, OR = 1.16, with the largest effects for eating, OR = 12.60, and personality disorders, OR = 2.97. In contrast, women were less likely than men to have a diagnosis of PTSD with comorbid alcohol use, OR = 0.69, and drug use disorders, OR = 0.72, with the largest effects for insomnia, OR = 0.42, and traumatic brain injury, OR = 0.17. No significant gender differences emerged for comorbid bipolar, obsessive–compulsive, panic/phobic, psychotic, or somatoform/dissociative disorders, ps = .029–.314. The results show gender differences in conditions comorbid with PTSD generally align with internalizing and externalizing dimensions. Differences in comorbidities with PTSD between women and men could have implications for treatment development and delivery.

中文翻译：

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美国水手和海军陆战队员中与创伤后应激障碍共病的疾病的性别差异

在创伤后应激障碍 (PTSD) 患者中，心理合并症（即精神健康障碍的共同发生）通常比例外情况更常见。研究表明，特定心理障碍的患病率估计因性别而异；然而，对于这些模式是否会在合并 PTSD 诊断的情况下持续存在，我们知之甚少。本研究使用 523,626 名在 8 年内入伍的现役美国水手和海军陆战队员的医疗记录，检查了与 PTSD 共病的患病率估计值的性别差异。使用独立性卡方检验，我们在 9,447 名诊断为 PTSD 的服务人员的子样本中检测到特定合并症的统计显着性别差异。或= 1.35；抑郁，OR = 1.71；和广泛性焦虑或其他焦虑障碍，OR = 1.16，对饮食的影响最大，OR = 12.60，人格障碍，OR = 2.97。相比之下，女性比男性更不可能被诊断为 PTSD 并伴有酒精使用，OR = 0.69，药物使用障碍，OR = 0.72，对失眠的影响最大，OR = 0.42，外伤性脑损伤，OR = 0.17。共病双相情感障碍、强迫症、恐慌/恐惧症、精神病或躯体形式/分离障碍没有显着的性别差异，ps = .029–.314。结果显示，在与 PTSD 共存的情况下，性别差异通常与内化和外化维度一致。女性和男性在 PTSD 合并症方面的差异可能会对治疗的开发和实施产生影响。