Converging evidence suggests that veterans with co-occurring PTSD/MDD represent a high-risk group for poor mental health compared to those with PTSD alone. To date, however, little is known about the specific factors that may increase vulnerability for and buffer risk for comorbid PTSD/MDD. The purpose of this study was to provide a population-based characterization of sociodemographic, risk, and protective variables associated with comorbid PTSD/MDD among U.S. military veterans. Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative survey of U.S. military veterans (n = 2,732). Analyses (1) compared veterans with PTSD alone and co-occurring PTSD/MDD on sociodemographic, military, and psychosocial characteristics; and (2) examined variables independently associated with PTSD/MDD status. Multivariable logistic regression analyses revealed that racial/ethnic minority status (odds ratio [OR] = 12.5), number of lifetime traumas (OR = 1.3), and time spent engaged in private religious/spiritual activities (OR = 1.8) were associated with PTSD/MDD status, while higher scores on measures of community integration (OR = 0.6) and dispositional optimism (OR = 0.7) were negatively associated with comorbid PTSD/MDD status. Relative importance analyses revealed that dispositional optimism (34%) and community integration (24%) explained the largest proportions of variance in PTSD/MDD comorbidity. Taken together, results of this study suggest that racial/ethnic minority status, greater lifetime trauma burden, and engagement in private religious/spiritual activities are key distinguishing characteristics of U.S. military veterans with comorbid PTSD/MDD vs. PTSD alone. They further underscore the need to study whether targeting community integration and optimism in prevention and treatment efforts may enhance clinical outcomes in this population.

中文翻译：

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与美国退伍军人共病 PTSD 和抑郁症相关的风险和保护因素：国家退伍军人健康和复原力研究的结果。


综合证据表明，与单独患有 PTSD 的退伍军人相比，同时患有 PTSD/MDD 的退伍军人是心理健康状况不佳的高危人群。然而，迄今为止，人们对可能增加 PTSD/MDD 共病脆弱性和缓冲风险的具体因素知之甚少。本研究的目的是提供基于人群的与美国退伍军人共病 PTSD/MDD 相关的社会人口统计学、风险和保护变量的特征。数据分析来自退伍军人国家健康和复原力研究，这是一项针对美国退伍军人的全国代表性调查（n = 2,732）。分析 (1) 比较单独患有 PTSD 和同时患有 PTSD/MDD 的退伍军人的社会人口、军事和社会心理特征； (2) 检查与 PTSD/MDD 状态独立相关的变量。多变量逻辑回归分析显示，种族/族裔少数群体状况（比值比 [OR] = 12.5）、一生创伤次数（OR = 1.3）以及从事私人宗教/精神活动的时间（OR = 1.8）与 PTSD 相关/MDD 状态，而社区融合 (OR = 0.6) 和性格乐观 (OR = 0.7) 测量得分较高与共病 PTSD/MDD 状态呈负相关。相对重要性分析显示，性格乐观 (34%) 和社区融入 (24%) 解释了 PTSD/MDD 共病的最大比例差异。总而言之，这项研究的结果表明，种族/族裔少数地位、更大的终生创伤负担以及参与私人宗教/精神活动是患有共病 PTSD/MDD 的美国退伍军人与单独患有 PTSD 的关键区别特征。 他们进一步强调需要研究以社区融合和乐观态度预防和治疗工作是否可以改善该人群的临床结果。