Posttraumatic Stress Disorder and Comorbidity: Untangling the Gordian Knot

The high rates of psychiatric comorbidity for individuals with posttraumatic stress disorder (PTSD) have long been noted. The conceptual, clinical and aetiological relationships between PTSD and other disorders are so interwoven and multi-determined that understanding and treating posttraumatic psychopathology can feel like trying to untangle the legendary Gordian knot. This paper examines the varying streams of research seeking to better understand this extensive comorbidity. These streams of research include examination of the bi-directional relationships in the development of PTSD and key mood, anxiety and substance use disorders; the study of the shared manifest and common higher order features across these disorders and investigations of underlying biopsychosocial vulnerabilities. Finally, the paper examines the preliminary findings emerging using the new DSM-5 criteria for PTSD and queries whether these revised criteria will address the issue of comorbidity and assist in untangling the knot of posttraumatic comorbidity. © 2014 Springer Science+Business Media New York.