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Family History of Depression Accurately Predicts Post Traumatic Stress Disorder in Rape Victims

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Duke Health News 919-660-1306

SAN JUAN, PUERTO RICO -- Duke University Medical Center researchers have found that women who have been victim of rape are almost twice as likely to suffer from post traumatic stress disorder (PTSD) if they have a family history of depressive illness.

According to the researchers, the findings can help physicians better predict which rape victims are at a greater risk from the debilitating effects of PTSD and help guide timely treatment. The findings of the Duke study were prepared for presentation Thursday (Dec. 14) by lead investigator Dr. Jonathan Davidson at the annual meeting of the American College of Neuropsychopharmacology. The study was funded by the National Institute of Mental Health.

"This is the first study to correlate such in-depth family histories of depressive illness with the incidence of PTSD in victims of rape," said Davidson, professor of psychiatry and director of Duke's psychiatric and anxiety outpatient program. PTSD is marked by an initial acute phase immediately after the trauma, followed by a long- term chronic phase, Davidson said. The disorder is characterized by such symptoms as sleep disorders, unwanted recurrent and disturbing memories, difficulty in concentrating, psychological numbness, and feelings of low self-esteem and self-worth. In severe cases, suicide and suicidal thoughts are possible, he said.

Of the 81 rape victims studied by the Duke researchers, 56 suffered from symptoms of PTSD and 25 didn't. All of the victims were over the age of 16. Duke researchers excluded cases of incest from the study.

In their study, the researchers developed detailed family psychiatric histories of the victims based on exhaustive interviews with more than 200 immediate family members and control groups.

"We found that 37 percent of the rape victims with PTSD had a family history of major depressive illness, which is almost double the 20 percent we would expect when compared to the control group," Davidson said. "In the group of rape victims who didn't develop PTSD, only 24 percent had a family history of depressive illness. So family history of depressive illness appears to be a clinically useful predictor of PTSD." The Duke researchers also used a scale for gauging the severity of the assault to determine if severity was an indicator of risk for the development of PTSD.

"After accounting for the severity of the assault, we still found that the family or previous history of depressive illness was an independent predictor of who will likely suffer from PTSD after a rape," Davidson said. "We need to pay especially close attention to issues of depression in these patients," Davidson continued. "These women are more likely to have unwarranted feeling of self-blame, guilt and shame, and they may even become suicidal. If we know there is a family history of depressive illness, we can watch these patients much more closely and make sure they get treated quickly."

According to Davidson, people can experience the symptoms of PTSD if they are involved in, or witness, a major traumatic event that causes intense horror, sadness or fear, including rape or other physical assaults, accidents, military combat experiences, natural disasters or political torture.

Davidson estimated that between 45 percent to 50 percent of Americans will experience such an intense event during their lifetimes, and about 25 percent of those will ultimately develop PTSD. Davidson said that some studies have shown that about 90 percent of rape victims suffer from the acute symptoms of PTSD immediately following the assault, and that by three months, about 50 percent suffer from the symptoms of chronic PTSD. "The trauma of sexual assault -- and the devastating effects to a woman's physical and psychological health -- is an important public health issue that needs to be addressed," Davidson said. "It is estimated that between 15 percent and 20 percent of American women will be victims of sexual assault at some point in their lives."

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