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Trauma and posttraumatic stress disorder in an urban Xhosa primary care population: prevalence, comorbidity, and service use patterns.
J Nerv Ment Dis. 2003 Apr; 191(4):230-6.JN

Abstract

Despite increased awareness of the prevalence and morbidity of psychiatric illnesses, relatively few studies have been undertaken in primary care settings in the African context. The authors determined the prevalence of trauma exposure and posttraumatic stress disorder (PTSD) in a South African township primary health care clinic and assessed associated demographic factors, comorbidity, service use, service satisfaction, and quality of life. Subjects were directly interviewed using translated, standardized instruments to assess variables described. Retrospective chart analysis assessed clinician case identification and psychotropic drug-prescribing habits. Of the 201 participants, 94% reported exposure to traumatic events (mean, 3.8). Trauma was associated with single status (p =.01), and PTSD was associated with poverty and single status (p =.04). Both sexes were equally likely to develop PTSD. PTSD (current; 19.9%), depression (37%), and somatization disorder (18.4%) were the most common diagnoses. Comorbidity with PTSD was high and included depression (75%, p <.01), somatization (35%, p <.01), and panic disorder (25%, p <.01). Levels of functional impairment were higher for subjects with PTSD, depression, and somatization than for those without (p <.05). PTSD comorbid with depression compounded impairment (p =.04). Levels of trauma, PTSD, and depression did not increase service use or dissatisfaction with services. Clinicians did not identify trauma (0%) or psychopathology (0%), and psychotropic medication was prescribed for only 1% of participants. In this population, trauma and PTSD were highly prevalent and associated with significant unidentified morbidity and comorbidity. Patients remain untreated for years in the current system of primary care consultations.

Authors+Show Affiliations

MRC Unit for Stress and Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, PO Box 19063, Tygerberg 7505, Cape Town, South Africa.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12695733

Citation

Carey, Paul D., et al. "Trauma and Posttraumatic Stress Disorder in an Urban Xhosa Primary Care Population: Prevalence, Comorbidity, and Service Use Patterns." The Journal of Nervous and Mental Disease, vol. 191, no. 4, 2003, pp. 230-6.
Carey PD, Stein DJ, Zungu-Dirwayi N, et al. Trauma and posttraumatic stress disorder in an urban Xhosa primary care population: prevalence, comorbidity, and service use patterns. J Nerv Ment Dis. 2003;191(4):230-6.
Carey, P. D., Stein, D. J., Zungu-Dirwayi, N., & Seedat, S. (2003). Trauma and posttraumatic stress disorder in an urban Xhosa primary care population: prevalence, comorbidity, and service use patterns. The Journal of Nervous and Mental Disease, 191(4), 230-6.
Carey PD, et al. Trauma and Posttraumatic Stress Disorder in an Urban Xhosa Primary Care Population: Prevalence, Comorbidity, and Service Use Patterns. J Nerv Ment Dis. 2003;191(4):230-6. PubMed PMID: 12695733.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trauma and posttraumatic stress disorder in an urban Xhosa primary care population: prevalence, comorbidity, and service use patterns. AU - Carey,Paul D, AU - Stein,Dan J, AU - Zungu-Dirwayi,Nompumelelo, AU - Seedat,Soraya, PY - 2003/4/16/pubmed PY - 2003/6/7/medline PY - 2003/4/16/entrez SP - 230 EP - 6 JF - The Journal of nervous and mental disease JO - J Nerv Ment Dis VL - 191 IS - 4 N2 - Despite increased awareness of the prevalence and morbidity of psychiatric illnesses, relatively few studies have been undertaken in primary care settings in the African context. The authors determined the prevalence of trauma exposure and posttraumatic stress disorder (PTSD) in a South African township primary health care clinic and assessed associated demographic factors, comorbidity, service use, service satisfaction, and quality of life. Subjects were directly interviewed using translated, standardized instruments to assess variables described. Retrospective chart analysis assessed clinician case identification and psychotropic drug-prescribing habits. Of the 201 participants, 94% reported exposure to traumatic events (mean, 3.8). Trauma was associated with single status (p =.01), and PTSD was associated with poverty and single status (p =.04). Both sexes were equally likely to develop PTSD. PTSD (current; 19.9%), depression (37%), and somatization disorder (18.4%) were the most common diagnoses. Comorbidity with PTSD was high and included depression (75%, p <.01), somatization (35%, p <.01), and panic disorder (25%, p <.01). Levels of functional impairment were higher for subjects with PTSD, depression, and somatization than for those without (p <.05). PTSD comorbid with depression compounded impairment (p =.04). Levels of trauma, PTSD, and depression did not increase service use or dissatisfaction with services. Clinicians did not identify trauma (0%) or psychopathology (0%), and psychotropic medication was prescribed for only 1% of participants. In this population, trauma and PTSD were highly prevalent and associated with significant unidentified morbidity and comorbidity. Patients remain untreated for years in the current system of primary care consultations. SN - 0022-3018 UR - https://www.unboundmedicine.com/medline/citation/12695733/Trauma_and_posttraumatic_stress_disorder_in_an_urban_Xhosa_primary_care_population:_prevalence_comorbidity_and_service_use_patterns_ L2 - https://doi.org/10.1097/01.NMD.0000061143.66146.A8 DB - PRIME DP - Unbound Medicine ER -