Symptom burden and work-related impairment among patients with PTSD and complex PTSD

Figures & data

Table 1. Frequencies of potentially traumatic events in % (multiple nominations possible).

	no-PTSD	PTSD	CPTSD	χ ^2
Type of traumatic event	(n = 511)	(n = 63)	(n = 88)	(6/N = 662)	p
Accident	49.3	50.8	60.2	3.577	.167
Natural disaster	15.9	20.6	33.0	14.711	.001
Acute life-threating disease	35.6	44.4	44.3	3.807	.149
Death of a family member or close friend	43.2	66.7	63.6	22.021	<.001
Traumatic experience at work	21.9	28.6	44.3	20.153	<.001
War	1.8	1.6	8.0	8.815	.009
Lifetime neglect	23.1	12.7	43.2	21.706	<.001
Criminal violence	17.8	14.3	42.0	28.613	<.001
Torture/hostage	2.0	0	3.4	1.845	.353
Physical assault	33.7	34.9	72.7	48.657	<.001
Lifetime sexual abuse	19.0	0	42.0	42.404	<.001
Other	13.3	15.9	25.0	8.036	.018
Frequency of traumatic events
One traumatic event	18.8	14.3	4.5	11.310	.003
Two traumatic events	16.2	23.8	13.6	2.968	.227
Three traumatic events	13.7	25.4	18.2	6.488	.039
Four and more traumatic events	33.9	31.7	63.6	29.396	<.001

Traumatic events were first-hand experienced or witnessed

Table 2. Differences in comorbid symptom severity in PTSD, CPTSD and no-PTSD at the beginning of rehabilitation.

	no-PTSD	PTSD	CPTSD	ANOVA
Symptom dimensions (SCL-90 Subscales)	M (SD)	M (SD)	M (SD)	F(2,659)	p	partial η^2
Somatization	.99 (.66)	1.42 (.66)	1.92 (.78)	77.619	< .001	.191
Obsessive-compulsive	1.35 (.78)	1.82 (.80)	2.62 (.75)	102.881	< .001	.238
Interpersonal sensitivity	.96 (.76)	1.18 (.71)	2.16 (.90)	90.547	< .001	.216
Depression	1.39 (.79)	1.83 (.67)	2.56 (.74)	89.920	< .001	.214
Anxiety	.98 (.65)	1.48 (.65)	2.19 (.84)	125.342	< .001	.276
Hostility	.74 (.62)	1.07 (.60)	1.58 (.85)	63.739	< .001	.162
Phobic anxiety	.64 (.74)	1.10 (.91)	2.00 (1.08)	109.019	< .001	.249
Paranoid ideation	.87 (.76)	1.28 (.82)	2.00 (.94)	78.869	< .001	.193
Psychoticism	.50 (.47)	.73 (.48)	1.41 (.81)	113.621	< .001	.256
Global severity index	.99 (.56)	1.38 (.51)	2.08 (.65)	143.308	< .001	.303

Table 3. Bonferroni adjusted post-hoc tests for SCL-90 subscales.

	no-PTSD – PTSD		no-PTSD – CPTSD		PTSD- CPTSD
Symptom dimensions	Mean Difference	p	Mean Difference	p	Mean Difference	p
Somatization	−.43	< .001	−.93	< .001	−.50	< .001
Obsessive-compulsive	−.47	< .001	−1.27	< .001	−.80	< .001
Interpersonal sensitivity	−.21	.115	−1.20	< .001	−.98	< .001
Depression	−.45	< .001	−1.17	< .001	−.72	< .001
Anxiety	−.51	< .001	−1.21	< .001	−.70	< .001
Hostility	−.33	< .001	−.83	< .001	−.50	< .001
Phobic anxiety	−.46	< .001	−1.36	< .001	−.90	< .001
Paranoid ideation	−.41	< .001	−1.12	< .001	−.71	< .001
Psychoticism	−.24	.002	−.91	< .001	−.67	< .001
Global severity index	−.39	< .001	−1.09	< .001	−.70	< .001

no-PTSD: n = 511; PTSD: n = 63; CPTSD: n = 88.

Table 4. Proportion of mental comorbidity (clinical diagnosis).

		no-PTSD		PTSD		CPTSD
Diagnose category	ICD-Code	n	%	n	%	n	%
Affective disorders	F30-F39	361	70,65	47	74,60	74	84,09
Depressive episode	F32	95	18,59	15	23,81	15	17,05
Recurrent depressive disorder	F33	253	49,51	30	47,62	57	64,77
Dysthymia	F34.1	10	1,96	1	1,59	2	2,27
Organic, including symptomatic, mental disorders	F00-F09	8	1.57	0	0	2	2.27
Mental and behavioural disorders due to psychoactive substance use	F10-F19	83	16,24	9	14,29	24	27,27
Schizophrenia, schizotypal and delusional disorders	F20-F29	6	1,17	0	0,00	2	2,27
Phobic and other anxiety disorders	F40-F41	129	25,24	24	38,10	32	36,36
Obsessive-compulsive disorder	F42	0	0,00	2	3,17	5	5,68
Reaction to severe stress, and adjustment disorders	F43	115	22,50	22	34,92	34	38,64
Post-traumatic stress disorder	F43.1	23	4,50	10	15,87	27	30,68
Adjustment disorders	F43.2	88	17,22	6	9,52	7	7,95
Dissociative disorders	F44	1	0,20	0	0,00	0	0,00
Somatoform disorders	F45	101	19,77	17	26,98	29	32,95
Other neurotic disorders	F48	7	1,37	1	1,59	0	0,00
Eating disorders	F50-F59	113	22,11	5	7,94	8	9,09
Disorders of adult personality and behaviour	F60-F69	49	9,59	4	6,35	20	22,73
Comorbidity		no-PTSD		PTSD		CPTSD
Number of mental disorders	F00-F99	n	%	n	%	n	%
1		133	26.0	15	23.8	6	6.8
2		235	46,0	25	39.7	32	36.4
3		98	19.2	16	25.4	31	35.2
≥ 4		43	8.4	7	11,1	19	21.6

Table 5. Proportion of the quantitative capacity rating in % (n).

	Last job			General job market
	Less than 3 h	3 – 6 h	6 and more h	Less than 3 h	3 – 6 h	6 and more h
No-PTSD	19.3% (98)	5.7% (29)	75% (381)	7.3% (37)	6.5% (33)	86.2% (438)
PTSD	25.4% (16)	7.9% (5)	66.7% (42)	9.5% (6)	11.1% (7)	79.4% (50)
CPTSD	43.2% (38)	11.4% (10)	45.5% (40)	25% (22)	11.4% (10)	63.6% (56)

Table 6. Proportion of qualitative impairments in working capacity in PTSD, CPTSD and no-PTSD at the beginning of rehabilitation.

	no-PTSD	PTSD	CPTSD	ANOVA
Capacity dimension	M(SD)	M(SD)	M(SD)	F(2,625)	p	partial η^2
Adherence to regulation	1.50 (1.38)	1.42 (1.32)	2.19 (1.89)	8.061	< .001	.025
Planning & structuring of tasks	2.11 (1.67)	2.40 (1.44)	3.23 (1.89)	15.310	< .001	.047
Flexibility & ability to adapt to changes	2.99 (1.71)	3.28 (1.92)	4.73 (1.76)	33.740	< .001	.097
Competency & application of knowledge	1.92 (1.42)	2.05 (1.46)	3.31 (1.89)	29.085	< .001	.085
Ability to make decisions & judgements	2.12 (1.39)	2.10 (1.19)	3.09 (1.87)	15.486	< .001	.047
Proactivity & spontaneous activity	2.75 (1.75)	3.18 (1.55)	4.12 (1.70)	21.585	< .001	.065
Endurance & perseverance	3.18 (1.73)	3.10 (1.78)	4.54 (1.89)	20.801	< .001	.062
Assertiveness	3.20 (1.80)	3.07 (1.80)	4.63 (1.74)	22.221	< .001	.066
Contact with others & small talk	2.50 (1.81)	2.73 (1.67)	3.94 (1.98)	20.966	< .001	.063
Group integration	2.34 (1.50)	2.27 (1.15)	3.50 (1.76)	20.630	< .001	.062
Dyadic or close relations	1.79 (1.51)	1.62 (1.35)	2.76 (2.13)	13.579	< .001	.042
Self-care	2.73 (1.45)	2.68 (1.33)	3.36 (1.62)	6.454	.002	.020
Mobility	2.15 (1.68)	2.90 (1.62)	3.58 (1.77)	26.878	< .001	.079

Table 7. Bonferroni adjusted post-hoc tests.

	no-PTSD – PTSD		no-PTSD – CPTSD		PTSD- CPTSD
Capacity dimension	Mean Difference	p	Mean Difference	p	Mean Difference	p
Adherence to regulation	.09	1.000	−.69	< .001	−.78	.006
Planning and structuring of tasks	−.29	.602	−1.12	< .001	−.83	.012
Flexibility and ability to adapt to changes	−.29	.653	−1.74	< .001	−1.45	< .001
Competency and application of knowledge	−.13	1.000	−1.38	< .001	−1.26	< .001
Ability to make decisions and judgements	.02	1.000	−.97	< .001	−.99	< .001
Proactivity and spontaneous activity	−.43	.202	−1.36	< .001	−.93	.005
Endurance and perseverance	.08	1.000	−1.36	< .001	−1.44	< .001
Assertiveness	.13	1.000	−1.43	< .001	−1.56	< .001
Contact with others and small talk	−.24	1.000	−1.44	< .001	−1.20	< .001
Group integration	.07	1.000	−1.16	< .001	−1.23	< .001
Dyadic or close relations	.17	1.000	−.97	< .001	−1.14	< .001
Self-care	.05	1.000	−.63	.001	−.68	.022
Mobility	−.75	.004	−1.42	< .001	−.68	.059

no-PTSD: n = 490; PTSD: n = 60; CPTSD: n = 78.