title: Adult health status of women HMO members with posttraumatic stress disorder symptoms.
abstract: Posttraumatic stress disorder (PTSD) is associated with high numbers of self-reported physical symptoms and functional disability in clinical samples, but little is known about the magnitude of these associations in population samples and using actual physician-coded diagnoses. We administered a 22-page survey to 1225 female HMO enrollees randomly selected from the current membership of a large, staff model HMO in Seattle, Washington. Using the PTSD Checklist (internally validated against a subset of clinical interviews) we compared women with low, moderate, and high scores with respect to differences in self-reported physical health status, functional disability (36-item short form health survey), numbers and types of self-reported health risk behaviors, common physical symptoms, and physician-coded ICD-9 diagnoses. Compared to women with low PTSD symptom severity, those with moderate or high severity reported significantly higher functional disability (P<.001), rates of abuse and neglect (P<.01 to P<.001), health risk behavior scores (P<0.05), as well as higher mean numbers of common physical symptoms (P<.05). Compared to women with low PTSD symptom severity those with moderate or high severity had significantly higher adjusted odds ratios for aversive physical symptoms (range, 1.7-10.1). The mean number of physician-coded ICD-9 diagnoses was also significantly higher in the both the moderate and high severity groups. Among female HMO members, PTSD symptoms are associated with a wide range of both self-reported and physician-coded adverse physical health outcomes.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Box 356560, Seattle, WA 98195-6560, USA. pavelcie@u.washington.edu
authors.forename: Paul S
authors.initials: PS
authors.lastname: Ciechanowski
authors.forename: Edward A
authors.initials: EA
authors.lastname: Walker
authors.forename: Joan E
authors.initials: JE
authors.lastname: Russo
authors.forename: Elana
authors.initials: E
authors.lastname: Newman
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Katon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005260:Female; D015438:Health Behavior; D006279:Health Maintenance Organizations; D006304:Health Status; D006801:Humans; D038801:International Classification of Diseases; D008875:Middle Aged; D012309:Risk-Taking; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires