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Suicidality in post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD)

Published online by Cambridge University Press:  13 August 2021

L. Longo*
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
T. Jannini
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
M. Merlo
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
V. Cecora
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
M. Gagliano
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
B. D’Imperia
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
A. Daverio
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
L. Monaco
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
R. Rossi
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
C. Niolu
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
A. Siracusano
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
G. Di Lorenzo
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
*
*Corresponding author.

Abstract

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Introduction

International Classification of Diseases 11th Revision (ICD-11) has inserted complex post-traumatic stress disorder (cPTSD) as a clinically distinct disorder, different from PTSD. The diagnosis of cPTSD has the same requirements for the one of PTSD, in addition to disturbances of self-organization (DSO – e.g., disturbances in relationships, affect dysregulation, and negative self-concept).

Objectives

This study aimed to explore suicidality in PTSD and cPTSD. We examined also the association between clinical dimensions of hopelessness (feelings, loss of motivation, future expectations) and other symptomatologic variables.

Methods

The sample, recruited at the Fondazione Policlinico Tor Vergata, Rome, Italy, consisted of 189 subjects, 132 diagnosed with PTSD, and 57 with cPTSD, according to the ICD-11 criteria. Participants underwent the following clinical assessments: Clinician-Administered PTSD Scale (CAPS), Impact of Event Scale-Revised (IES), Beck Depression Inventory (BDI), Symptom Checklist-90-Revised (SCL-90), Dissociative Experience Scale (DES), Beck Hopelessness Scale (BHS).

Results

cPTSD showed significantly higher BHS-total (p = 0.01) and BHS-loss of motivation subscale (p <0.001) scores than PTSD. Besides, cPTSD showed significantly higher scores in all clinical variables except for the IES-intrusive subscale. By controlling for the confounding factor “depression”, suicidality in cPTSD (and in particular the BHS-total) appears to be correlated with IES-total score (p = 0.042) and with DES-Absorption (p = 0.02). Differently, no such correlations are found in PTSD.

Conclusions

Our study shows significant symptomatologic differences between PTSD and cPTSD, including suicidality. Indeed, suicidality in cPTSD appears to be correlated with the “loss of motivation” dimension, which fits well within the ICD-11 criteria of DSO.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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