9%) affective disorders, and 12 of 61

(19.6%) other psychotic disorders. The R-PTSD inventory facilitated diagnosis of comorbid PTSD in 91.8% of patients (56 of 61). As previously shown, the inventory correlated well with the Schizophrenia Clinical Interview for Diagnosis (SCID). Thus, comorbid PTSD can be said to be reliably diagnosed in the overwhelming majority of subjects in the present study. Inhibitors,research,lifescience,medical The IES results demonstrated a significant difference between intrusive and avoidance symptoms. While both subscales were scored as significantly Selleck ZD1839 higher than the reported means for the normal population, intrusions were scored as notably more prominent than avoidance. Mean intrusion score was 42.7 ±4.1 (range Inhibitors,research,lifescience,medical 3651) and mean avoidance score was 29.7±3.4 (range 2731); < 0.01 [paired Student /-test]). The IES scores in the present study are in the range of a previous study of elderly subjects suffering from PTSD reported by our group.33 Discussion Our sample represents a unique group of elderly Holocaust survivors who show a high comorbidity of chronic PTSD (91.8%), Inhibitors,research,lifescience,medical with psychotic disorders more than 50 years after the experience of the massive psychic trauma of the Holocaust. The occurrence of chronic PTSD of such magnitude for an extremely prolonged period is striking. It is significantly higher than the rate

reported for war veterans, ranging from 12.4%14 to 45%. 13 This difference may be related to Inhibitors,research,lifescience,medical the unique nature of the Holocaust trauma, combining dehumanization, confrontation with death, and massive loss for a prolonged period.21 Beal15 demonstrated that the co-occurrence of imprisonment in addition to the experience of combat led to a higher incidence of PTSD and other psychological symptoms, compared to combat experience alone. Furthermore, Kidson ct al13 show that the specific nature

of the Inhibitors,research,lifescience,medical traumatic experience, such as taking of casualties, or the experience of combat stress, resulted in more pronounced severity, and was significantly associated with the occurrence of PTSD in WWII veterans. Thus, the specific nature of the traumatic experience may influence the occurrence of PTSD and its persistence over time. Beyond this aspect, MTMR9 the coexistence of a severe psychotic disorder in our scries of patients seems to bc decisive. As demonstrated by Kidson et al,13 even minor pathologies, such as anxiety and depressive disorders, were more common in war veterans with PTSD. Therefore, this seems to suggest that the severity of the coexistent psychiatric morbidity, such as schizophrenia, may explain the high incidence of chronic PTSD present for such a prolonged period. It is difficult to say whether the occurrence of PTSD in our group represents lifelong suffering, beginning close to the end of the traumatic experience and persisting for more than 50 years, or whether it represents a phase of symptomatic reactivation occurring in WWII veterans in their old age, as demonstrated by Macleod.