PTSD and depression construct: prevalence and predictors of co-occurrence in a South Lebanese civilian sample

BACKGROUND: Armed conflict, occupation, and political and economic instability that are particularly experienced by the civilian Lebanese population of South Lebanon would almost inevitably affect these individuals psychologically. Therefore, identifying predictors of co-occurring mental disorders is paramount to sound assessment and intervention planning. OBJECTIVE: This study aims to determine the prevalence and predictors of co-occurring posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) in a post-war population from South Lebanon. METHOD: A total of 991 citizens from 10 villages were interviewed using a cross-sectional design through random sampling. The prevalence of PTSD, MDD, or both was 23.4%. To identify predictors of PTSD and depression co-occurrence, multinomial logistic regression was used. Participants were divided into four groups (participants with no PTSD or depression, participants with PTSD only, participants with depression only, and participants with PTSD–depression comorbidity). RESULTS: Among the significant predictors of PTSD–depression co-occurrence, female gender, health problems, social life events, and witnessed traumatic events were most consistently found. Additionally, employment and educational status, as well as social support, were found to significantly predict co-occurrence. CONCLUSIONS: Results reveal the distinct risk and protective factors that characterize the PTSD-depression profile. These findings will hopefully assist in the development of interventions that are sensitive to individuals’ psychosocial milieu. HIGHLIGHTS OF THE ARTICLE: Identifying predictors of PTSD-depression co-occurrence is paramount to sound assessment and intervention planning. Comorbidity was most strongly predicted by female gender, health problems, social life events, and HTQ witnessed events. Unemployment, having below secondary education, and low social support were also found to predict comorbidity. The substantial overlap in the risk factor profiles that were observed may suggest that PTSD and MDD co-occurrence represent a single general construct derived from traumatic stress.