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There is much overlap between PTSD and major mood disorders. Symptoms such as psychic numbing, irritability, sleep disturbance, fatigue, anhedonia, impairments in family and social relationships, anger, concern with physical health, and pessimistic outlook may occur in both disorders. In some veteran outreach populations, 70%–80% of patients meet diagnostic criteria for both disorders. Major depression is a frequent complication of PTSD; when it occurs, it must be treated aggressively, because comorbidity carries an increased risk of suicide. If major depression develops secondary to PTSD, both disorders should be diagnosed. Dysthymic symptoms are frequently secondary to PTSD, but if of sufficient severity, the additional diagnosis of dysthymic disorder should be made.

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