Steven Stellman - Comorbid persistent lower respiratory symptoms and posttraumatic stress disorder 5-6 years post-9/11 in responders enrolled in the World Trade Center Health Registry

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      Publication Details (including relevant citation   information):

      Friedman, S. M., Farfel, M. R., Maslow, C. B., Cone, J. E.,   Brackbill, R. M., Stellman, S. D. 56 (11) 1251-61-

      Abstract: BACKGROUND: Co-occurrence of lower   respiratory symptoms (LRS) and posttraumatic stress disorder   (PTSD) has been increasingly recognized among responders and   survivors of the World Trade Center (WTC) disaster. Information   is limited on the degree which comorbidity intensifies symptoms   and compromises quality of life across exposed groups. METHODS:   Among responders who completed the first and second Registry   surveys, measures of respiratory illness, psychological distress,   and diminished quality of life were compared between responders   comorbid for LRS and PTSD and responders with only LRS or PTSD.   RESULTS: Of 14,388 responders, 40% of those with LRS and 57% of   those with PTSD were comorbid. When demographic and WTC   exposure-related factors were controlled, comorbid responders   compared to those with LRS alone were twice as likely to have   frequent dyspnea and to have sought care for dyspnea. Compared to   responders with PTSD alone, comorbid responders were 2.1 times   more likely to report intense re-experiencing of the disaster,   2.5 times more likely to express feelings of significant   non-specific psychological distress, and 1.4 times more likely to   have received mental health care. Comorbid responders were   approximately three times more likely to report only fair or poor   general health and more than twice as likely to report being   unable to perform usual activities for >/=14 of 30 days before   interview. CONCLUSIONS: Outcomes in comorbid responders were   similar to or more severe than in comorbid survivors. Health care   and disaster relief providers must suspect comorbid illness when   evaluating responders' respiratory or mental illnesses and   consider treatment for both.

      Address (URL): http://www.ncbi.nlm.nih.gov/pubmed/23794365