Long-term PTSD and comorbidity with depression among World Trade Center responders

This chapter explores the prevalence, correlates, and consequences of posttraumatic stress disorder (PTSD) in World Trade Center (WTC) responders. Rates of WTC-related PTSD varied depending on when and how the assessments were conducted. In the Stony Brook cohort, 17% developed PTSD during the first 13 years after the accident; half had active illness 11-13 years later. Consistent with clinical and epidemiologic research, several studies found that PTSD was associated with medical conditions and impaired functioning. PTSD was also highly comorbid with depression, and comorbidity was associated with very poor outcomes. In the Stony Brook cohort, the majority of responders with comorbid PTSD and depression were out of the workforce (65.2%), diagnosed with a WTC medical condition (81.9%), and had impairments in life satisfaction (83.2%), relationships with friend (52.4%), and social support (63.1%). The data support the need for continued monitoring and treatment of both conditions.