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Prevalence of posttraumatic stress disorder in Veterans Affairs primary care clinics.
Gen Hosp Psychiatry. 2005 May-Jun; 27(3):169-79.GH

Abstract

Although posttraumatic stress disorder (PTSD) is relatively common in community epidemiologic surveys (5-6% for men, 10-12% for women), and psychiatric patients with PTSD are known to have poor functioning and high levels of psychiatric comorbidity, there are no studies that address PTSD prevalence, functioning, and burden in primary care settings. This article reports on (1) the prevalence of PTSD using Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition diagnostic criteria in Veterans Affairs (VA) primary care settings, (2) associated sociodemographic characteristics and comorbidities, (3) functional status related to PTSD, (4) the extent to which PTSD was recognized by providers and (5) health services use patterns (including specialty mental health) of PTSD patients. Patients were randomly selected from those who had an outpatient visit in FY 1999 at one of four VA hospitals; 888 patients consented (74.1% of 1198 contacted); 746 patients (84.0% of consenting patients; 62.3% of contacted patients) were reached for telephone diagnostic interviews. Diagnostic interviews with the Clinician Administered PTSD Scale yielded estimates of current PTSD prevalence of 11.5%. At statistically significant levels, PTSD was positively associated with a variety of comorbid psychiatric disorders, war zone service, age <65 years, not working, less formal education and decreased functioning. Of patients diagnosed with PTSD by study procedures, 12-month medical record review indicated that providers identified only 46.5% and only 47.7% had used mental health specialty services. PTSD-positive [PTSD(+)] patients who used mental health care in the past 12 months were more apt to be identified as having PTSD than nonmental health service users (78.0% vs. 17.8%). Although PTSD(+) patients had more medical record diagnoses than PTSD-negative [PTSD(-)] patients (6.28 vs. 4.95), their use of primary care, urgent care and inpatient care was not different from PTSD(-) patients.

Authors+Show Affiliations

Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, 109 Bee Street, Charleston, SC 29401-5799, USA. magrudkm@musc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

15882763

Citation

Magruder, Kathryn M., et al. "Prevalence of Posttraumatic Stress Disorder in Veterans Affairs Primary Care Clinics." General Hospital Psychiatry, vol. 27, no. 3, 2005, pp. 169-79.
Magruder KM, Frueh BC, Knapp RG, et al. Prevalence of posttraumatic stress disorder in Veterans Affairs primary care clinics. Gen Hosp Psychiatry. 2005;27(3):169-79.
Magruder, K. M., Frueh, B. C., Knapp, R. G., Davis, L., Hamner, M. B., Martin, R. H., Gold, P. B., & Arana, G. W. (2005). Prevalence of posttraumatic stress disorder in Veterans Affairs primary care clinics. General Hospital Psychiatry, 27(3), 169-79.
Magruder KM, et al. Prevalence of Posttraumatic Stress Disorder in Veterans Affairs Primary Care Clinics. Gen Hosp Psychiatry. 2005 May-Jun;27(3):169-79. PubMed PMID: 15882763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of posttraumatic stress disorder in Veterans Affairs primary care clinics. AU - Magruder,Kathryn M, AU - Frueh,B Christopher, AU - Knapp,Rebecca G, AU - Davis,Lori, AU - Hamner,Mark B, AU - Martin,Renée Hebert, AU - Gold,Paul B, AU - Arana,George W, PY - 2004/05/10/received PY - 2004/11/11/accepted PY - 2005/5/11/pubmed PY - 2005/9/10/medline PY - 2005/5/11/entrez SP - 169 EP - 79 JF - General hospital psychiatry JO - Gen Hosp Psychiatry VL - 27 IS - 3 N2 - Although posttraumatic stress disorder (PTSD) is relatively common in community epidemiologic surveys (5-6% for men, 10-12% for women), and psychiatric patients with PTSD are known to have poor functioning and high levels of psychiatric comorbidity, there are no studies that address PTSD prevalence, functioning, and burden in primary care settings. This article reports on (1) the prevalence of PTSD using Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition diagnostic criteria in Veterans Affairs (VA) primary care settings, (2) associated sociodemographic characteristics and comorbidities, (3) functional status related to PTSD, (4) the extent to which PTSD was recognized by providers and (5) health services use patterns (including specialty mental health) of PTSD patients. Patients were randomly selected from those who had an outpatient visit in FY 1999 at one of four VA hospitals; 888 patients consented (74.1% of 1198 contacted); 746 patients (84.0% of consenting patients; 62.3% of contacted patients) were reached for telephone diagnostic interviews. Diagnostic interviews with the Clinician Administered PTSD Scale yielded estimates of current PTSD prevalence of 11.5%. At statistically significant levels, PTSD was positively associated with a variety of comorbid psychiatric disorders, war zone service, age <65 years, not working, less formal education and decreased functioning. Of patients diagnosed with PTSD by study procedures, 12-month medical record review indicated that providers identified only 46.5% and only 47.7% had used mental health specialty services. PTSD-positive [PTSD(+)] patients who used mental health care in the past 12 months were more apt to be identified as having PTSD than nonmental health service users (78.0% vs. 17.8%). Although PTSD(+) patients had more medical record diagnoses than PTSD-negative [PTSD(-)] patients (6.28 vs. 4.95), their use of primary care, urgent care and inpatient care was not different from PTSD(-) patients. SN - 0163-8343 UR - https://www.unboundmedicine.com/medline/citation/15882763/Prevalence_of_posttraumatic_stress_disorder_in_Veterans_Affairs_primary_care_clinics_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-8343(04)00136-7 DB - PRIME DP - Unbound Medicine ER -