PTSD and substance use: unrecognized sequelae of bioterrorism in primary care providers.
BACKGROUND
Psychological casualties following public health emergencies are likely to significantly outnumber physical casualties. However, postevent psychological disorders may be underrecognized by primary care providers (PCPs).


METHODS
Rural PCPs in northern and central Florida were interviewed using a series of open-ended questions to assess knowledge of likely mental disorders, their risk factors, and preferred treatment options following such events (n=21).


RESULTS
PTSD was identified by 14% and substance abuse by 10% of the sample. Physicians were significantly more likely to identify posttraumatic stress disorder (PTSD) as an expected postevent psychological disorder than nonphysician providers. PCPs were significantly more likely to endorse counseling (86%) than medications (43%) as a preferred treatment option.


CONCLUSIONS
Our findings support the need for increased education and training regarding the mental health consequences of bioterrorism in rural PCPs, particularly for nursing-level and other nonphysician providers. Improvements in knowledge may enhance preparedness for such emergencies.
Tsao
Jennie C I
JC
Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA. jtsao@mednet.ucla.edu
Dobalian
Aram
A
Wiens
Brenda A
BA
Gylys
Julius A
JA
Clawson
Art
A
Brooks
Robert
R
D000328:Adult; D023482:Bioterrorism; D005260:Female; D005431:Florida / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000592:standards*; D006801:Humans; D015994:Incidence; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011320:Primary Health Care; D012424:Rural Population; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000209:etiology*