title: Clinical characteristics and health service use of veterans with comorbid bipolar disorder and PTSD.
abstract: OBJECTIVE
  This study aimed to increase the understanding of the clinical characteristics and utilization of health services among veterans with comorbid bipolar disorder and posttraumatic stress disorder (PTSD).
  
  
  METHODS
  A retrospective chart review was conducted that examined the clinical and health service use data of 139 male veterans with bipolar disorder (N=49), PTSD (N=49), or comorbid bipolar disorder and PTSD (N=41) who obtained services over two years from the Department of Veterans Affairs Salt Lake City Health Care System.
  
  
  RESULTS
  Compared with patients with bipolar disorder or those with PTSD alone, those with both conditions had significantly higher mean Clinical Global Impression-Severity scores and required more frequent inpatient psychiatric treatment. Patients with both conditions and those with bipolar disorder were significantly less likely to have received psychotherapy and antidepressant pharmacotherapy than patients with PTSD.
  
  
  CONCLUSIONS
  Patients with both conditions have a more severe illness course than those with bipolar disorder alone. Psychotherapy and antidepressant pharmacotherapy may be underutilized among patients with comorbid bipolar disorder and PTSD.
authors.affiliation: Department of Mental Health, George E. Wahlen Department of Veterans Affairs Medical Center, 500 Foothill Blvd., Salt Lake City, UT 84148, USA. john.thatcher@hsc.utah.edu
authors.forename: John W
authors.initials: JW
authors.lastname: Thatcher
authors.forename: William R
authors.initials: WR
authors.lastname: Marchand
authors.forename: G William
authors.initials: GW
authors.lastname: Thatcher
authors.forename: Alana
authors.initials: A
authors.lastname: Jacobs
authors.forename: Cody
authors.initials: C
authors.lastname: Jensen
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000503:physiopathology*; D015897:Comorbidity; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology*; D014589:Utah; D014728:Veterans / Q000523:psychology*