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Prim Care Companion J Clin Psychiatry. 2001 Oct;3(5):211-217.
Trauma and Posttraumatic Stress Disorder
in Primary Care Patients.
Bruce SE, Weisberg RB, Dolan RT, Machan JT, Kessler RC, Manchester G, Culpepper
L, Keller MB.
Department of Psychiatry and Human Behavior, Brown University, Providence,
R.I.; Harvard University Medical School and the Boston University School of Medicine,
Boston, Mass.; and the University of Massachusetts Medical Center, Worcester.
BACKGROUND: This article examines the nature of psychological trauma
and posttraumatic stress disorder (PTSD) in 504 patients recruited from primary
care settings. METHOD: Patients were screened for anxiety in waiting rooms at
14 general medical settings, and those with a sufficient number and severity of
anxiety symptoms were administered a standardized diagnostic clinical interview.
Those who met DSM-IV criteria for an anxiety disorder and who were willing to
participate were included in this study. Of the 504 patients, 185 met DSM-IV criteria
for PTSD.
RESULTS: Results indicated that 418 (83%) of primary care patients in our
sample reported at least 1 traumatic event in their lifetime. The most prevalent
traumas experienced by the entire sample of participants were witnessing others
being seriously injured or killed, serious accidents, and rape. Of those participants
with PTSD, rape was the strongest predictor of a PTSD diagnosis. Analyses examining
gender differences indicated that, for women, a history of other unwanted sexual
contact or witnessing a sexual assault, being attacked with a weapon or with intent
to kill, or witnessing someone being injured were found to be risk factors for
a PTSD diagnosis. Examination of clinical characteristics indicated a high rate
of comorbidity of psychiatric disorders among patients with PTSD, including high
rates of alcohol/substance abuse, depression, and suicide attempts.
CONCLUSION: These findings emphasize the continued need to assess patients
presenting at general medical facilities about trauma history.
PMID: 15014575 [PubMed - as supplied by publisher]
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