Post-traumatic stress disorder and psychiatric comorbidity: neurobiological, clinical, and social aspects

Relevance of comorbidity research in psychiatry is determined by several key factors. First, the presence of comorbid conditions significantly complicates the diagnostic process. Significant overlap in symptoms across various mental disorders can lead to differential diagnostic difficulties and even artificial comorbidity. Second, comorbid mental disorders are typically associated with a more severe course, poorer treatment response, increased risk of relapse, and a less favorable prognosis.

Рurpose. To study the comorbidity of post-traumatic stress disorder (PTSD) with other mental disorders, including affective, anxiety, psychotic, and addictive disorders.

Results. This article examines the comorbidity of post-traumatic stress disorder (PTSD) with other mental disorders, including affective, anxiety, psychotic, and addictive disorders. The high prevalence of comorbid conditions, their negative impact on the clinical course, treatment effectiveness, and social adaptation of patients, is highlighted. Epidemiological data, neurobiological mechanisms (reduced hippocampal volume, amygdala dysfunction, HPA axis dysfunction), and psychological factors of comorbidity, such as emotional dysregulation and avoidant behavior, are described. Particular attention is paid to the diagnostic challenges due to symptomatic overlap and the need for structured interviews. Therapeutic strategies, including pharmacotherapy and psychotherapy, are discussed, emphasizing the importance of an integrative approach. A conclusion is drawn regarding the need for transdiagnostic modeling and the integration of psychiatric care into the healthcare system.

Conclusions. The comorbidity of PTSD with other mental disorders is not only a common clinical phenomenon but also a complex problem requiring a comprehensive approach at the individual, systemic, and societal levels. Improving the understanding of the nature of these combinations, optimizing diagnosis and treatment, and developing preventive strategies are key tasks in modern psychiatry.

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