Mental health treatment received by primary care patients with posttraumatic stress disorder.
BACKGROUND
Posttraumatic stress disorder (PTSD) is receiving growing attention as a pervasive and impairing disorder but is still undertreated. Our purpose was to describe the characteristics of mental health treatment received by primary care patients diagnosed with PTSD.


METHODS
4383 patients from 15 primary care, family practice, or internal medicine clinics were screened for anxiety symptoms using a self-report questionnaire developed for the study. Those found positive for anxiety symptoms (N = 539) were interviewed with the Structured Clinical Interview for DSM-IV. Of these patients, 197 met diagnostic criteria for PTSD and were examined in the present study regarding the rates and types of mental health treatment they were currently receiving. Data were gathered from July 1997 to May 2001.


RESULTS
Nearly half (48%) of the patients in general medical practice with PTSD were receiving no mental health treatment at the time of intake to the study. Of those receiving treatment, psychopharmacologic interventions were most common. Few patients were receiving empirically supported psychosocial interventions. Current comorbid major depressive disorder and current comorbid panic disorder with agoraphobia were significantly associated with receiving mental health treatment (major depressive disorder, p <.10; panic disorder with agoraphobia, p <.05). The most common reason patients gave for not receiving medication was the failure of physicians to recommend such treatment, which was also among the most common reasons for not receiving psychosocial treatment.


CONCLUSIONS
Despite the morbidity, psychosocial impairment, and distress associated with PTSD, substantial proportions of primary care patients with the disorder are going untreated or are receiving inadequate treatment. Results suggest a need for better identification and treatment of PTSD in the primary care setting.
Rodriguez
Benjamin F
BF
Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, R.I., USA. benrodii@siu.edu
Weisberg
Risa B
RB
Pagano
Maria E
ME
Machan
Jason T
JT
Culpepper
Larry
L
Keller
Martin B
MB
D000328:Adult; D000379:Agoraphobia / Q000453:epidemiology / Q000628:therapy; D001008:Anxiety Disorders / Q000453:epidemiology / Q000628:therapy; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000453:epidemiology / Q000628:therapy; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010348:Patient Care Team; D011320:Primary Health Care; D011613:Psychotherapy / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000008:administration & dosage*; D012237:Rhode Island; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome
D011619:Psychotropic Drugs