Longitudinal course of Posttraumatic Stress Disorder and Posttraumatic Stress Disorder symptoms in a community sample of adolescents and young adults

Objective: Few studies have focused on the natural course of posttraumatic stress disorder ( PTSD) and its determinants in samples of the general population. The authors examined determinants of remission and chronicity of PTSD and associations with other disorders in a prospective community sample. Method: The data were drawn from a prospective, longitudinal epidemiological study of adolescents and young adults ( age 14-24 years) in Munich, Germany (N = 2,548). The course of PTSD from baseline to follow-up 34-50 months later was studied in 125 respondents with DSM-IV PTSD or subthreshold PTSD at baseline. Results: Although 52% of the PTSD cases remitted during the follow-up period, 48% showed no significant remission of PTSD symptoms. Respondents with a chronic course were more likely to experience new traumatic event(s) during follow-up (odds ratio = 5.21, 95% confidence interval [CI] = 1.95-13.92), to have higher rates of avoidant symptoms at baseline (odds ratio = 10.16, 95% CI = 1.73-59.51), and to report more help seeking (odds ratio = 5.50, 95% CI = 1.04-29.05), compared to respondents with remission. Rates of incident somatoform disorder (odds ratio = 4.24, 95% CI = 1.60-11.19) and other anxiety disorders (odds ratio = 4.07, 95% CI = 1.15-14.37) were also significantly associated with a chronic course. Conclusions: PTSD is often a persistent and chronic disorder. Specific symptom clusters-especially avoidant symptoms-might be associated with the course of PTSD. In addition, the occurrence of new traumatic events differentiates PTSD cases with a chronic course from those with remission.