Assessment of post-traumatic stress disorder and comorbidity

The symptoms of lifetime post-traumatic stress disorder (PTSD) and comorbid diagnoses were compared among 502 combat-experienced soldiers under examination for compensation-related purposes to confirm or deny the diagnosis of PTSD and 196 soldiers with combat experience without any psychiatric disorder. The two groups were matched with regard to duration of combat experience, time between combat experience and the study, age, marital status, and education. PTSD was diagnosed by psychiatrists with a structured clinical interview according to the research version of the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders. The psychologists applied the Mississippi Scale for Combat-Related PTSD, Watson's criteria for PTSD, the Minnesota Multiphasic Personality Inventory version 201, and the Trauma Questionnaire. Also, a very detailed heteroanemnestic questionnaire was completed by social workers. Medical documentation and data from the combat services were provided during the examination for compensation-related purposes. After psychiatric and psychological assessment, 20% of the combat-experienced soldiers under examination for compensation-related purposes were diagnosed with lifetime PTSD, 47% were diagnosed with PTSD and comorbid disorders, 6% were diagnosed with PTSD and enduring personality change, and 5% were diagnosed with adjustment disorder. Twelve percent did not fulfill any diagnostic psychiatric criteria, and 10% fulfilled diagnostic criteria for other psychiatric disorders, although they had previous medical documentation confirming PTSD diagnoses. Correlation coefficients between psychiatric and psychological assessment were significant, indicating their complementarity in reaching the final diagnosis. It is necessary to include many different assessment methods in the examination for forensic or compensation-related purposes to obtain a more objective assessment.