Journal of psychiatric research · 2025
Comorbidity characteristics of PTSD with anxiety and depression in patients with accidental injuries: Findings from joint cross-sectional and longitudinal studies.
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Chen Weihang, Dai Xiu, Chu Xiangyuan, Jiang Xuheng, Qi Guojia, Zhao Shimin, Zhou Yanna, Shi Xiuquan
Аннотация
BACKGROUND: This study aims to analyze the dynamic symptom interaction pathways and temporal causal relationships among post-traumatic stress disorder (PTSD), anxiety, and depression in patients with accidental injuries, and to establish a system of psychological intervention targets for this population.
METHODS: This prospective longitudinal study was conducted from November 2023 to December 2024 in three tertiary general hospitals in Southwest China. Baseline assessments were completed 3-10 days post-trauma (T0), followed by follow-ups at 1 month (T1), 3 months (T2), and 6 months (T3).
RESULTS: 382 patients who completed T1 follow-up were included as the main analysis samples. The comorbidity rates of PTSD, anxiety and depression decreased gradually (T1 = 22.8 %, T2 = 21.2 %, T3 = 15.6 %). The longitudinal psychopathological network analysis showed that PTSD9 (Loss of interest) and D1 (Anhedonia) (edge weight = 0.22) were the main connections in T1 stage. In T2, A3 (Worrying) and D6 (Depressed mood) (edge weight = 0.30) were added. At T3 stage, there were positive emotional correlation between A4 (Relaxed feeling) and D7 (Enjoyment of activities) (edge weight = 0.21). Cross-lagged panel model analysis indicated that depressive symptoms positively predicted subsequent PTSD symptoms (T1 → T2: β = 0.583, P < 0.01; T2 → T3: β = 0.792, P < 0.05) and anxiety symptoms (T1 → T2: β = 0.268, P < 0.05; T2 → T3: β = 0.282, P < 0.001).
CONCLUSION: There was a dynamic evolution of PTSD, anxiety, and depression following accidental injuries, highlighting the need to establish temporally targeted intervention pathways to disrupt the pathogenic process.
METHODS: This prospective longitudinal study was conducted from November 2023 to December 2024 in three tertiary general hospitals in Southwest China. Baseline assessments were completed 3-10 days post-trauma (T0), followed by follow-ups at 1 month (T1), 3 months (T2), and 6 months (T3).
RESULTS: 382 patients who completed T1 follow-up were included as the main analysis samples. The comorbidity rates of PTSD, anxiety and depression decreased gradually (T1 = 22.8 %, T2 = 21.2 %, T3 = 15.6 %). The longitudinal psychopathological network analysis showed that PTSD9 (Loss of interest) and D1 (Anhedonia) (edge weight = 0.22) were the main connections in T1 stage. In T2, A3 (Worrying) and D6 (Depressed mood) (edge weight = 0.30) were added. At T3 stage, there were positive emotional correlation between A4 (Relaxed feeling) and D7 (Enjoyment of activities) (edge weight = 0.21). Cross-lagged panel model analysis indicated that depressive symptoms positively predicted subsequent PTSD symptoms (T1 → T2: β = 0.583, P < 0.01; T2 → T3: β = 0.792, P < 0.05) and anxiety symptoms (T1 → T2: β = 0.268, P < 0.05; T2 → T3: β = 0.282, P < 0.001).
CONCLUSION: There was a dynamic evolution of PTSD, anxiety, and depression following accidental injuries, highlighting the need to establish temporally targeted intervention pathways to disrupt the pathogenic process.