title: Female veterans seeking medical care at Veterans Affairs primary care clinics: psychiatric and medical illness burden and service use.
abstract: OBJECTIVE
  To examine rates of medical and psychiatric disorders among 187 female veterans recruited at four Veterans Affairs Medical Centers (VAMCs), the recognition of such disorders by VAMC care providers, and the use of relevant medical and mental health services by women both within and outside of the VA setting.
  
  
  METHODS
  We used a cross-sectional, epidemiological design incorporating self-report measures, structured interviews, and chart reviews to obtain relevant information for analyses.
  
  
  RESULTS
  Forty-four percent (43.9%) of women met criteria for at least one psychiatric disorder; 34.0% of these women met criteria for two or more additional psychiatric diagnoses, and concordance rates between interview and chart diagnoses were low. Ninety-five percent (95.2%) of women had a medical condition noted in their charts; 86.6% had two or more additional medical conditions, and a significant number of women had both medical and psychiatric diagnoses. Forty-four percent (43.9%) of women with an identified mental health condition received specialized mental health care by the VA in the past year.
  
  
  CONCLUSIONS
  Findings from this study suggest that female veterans treated in VAMCs had significant medical and psychiatric problems, and these women might not be getting their health care needs adequately met through the VA health care system. In light of our findings, we discuss relevant implications and future directions for research.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, PO Box 250861, Charleston, SC 29425, USA. grubaugh@musc.edu
authors.forename: Anouk L
authors.initials: AL
authors.lastname: Grubaugh
authors.forename: Jeannine
authors.initials: J
authors.lastname: Monnier
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Magruder
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Knapp
authors.forename: B Christopher
authors.initials: BC
authors.lastname: Frueh
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008485:Medical Audit; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009017:Morbidity; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*; D014932:Women's Health Services / Q000592:standards / Q000706:statistics & numerical data*