Trauma exposure and posttraumatic stress disorder among primary care patients with bipolar spectrum disorder.
OBJECTIVE
To examine relationships between exposure to trauma, bipolar spectrum disorder (BD) and posttraumatic stress disorder (PTSD) in a sample of primary care patients.


METHODS
A systematic sample (n = 977) of adult primary care patients from an urban general medicine practice were interviewed with measures including the Mood Disorders Questionnaire, the PTSD Checklist-Civilian Version, and the Medical Outcomes Study 12-Item Short Form Health Survey.


RESULTS
Compared with patients who screened negative for BD (n = 881), those who screened positive (n = 96) were 2.6 times [95% confidence interval (CI): 1.6-4.2] as likely to report physical or sexual assault, and 2.9 times (95% CI: 1.6-5.1) as likely to screen positive for current PTSD. Among those screening positive for BD, comorbid PTSD was associated with significantly worse social functioning. These results controlled for selected background characteristics, current major depressive episode, and current alcohol/drug use disorder.


CONCLUSIONS
In an urban general medicine setting, trauma exposure was related to BD, and the frequency of PTSD among patients with BD appears to be common and clinically significant. These results suggest an unmet need for mental health care in this specific population and are especially important in view of available treatments for BD and PTSD.
Neria
Yuval
Y
Department of Psychiatry, College of Physicians and Surgeons, Mailman School of Public Health, Columbia University Medical Center, New York, NY 10032, USA.
Olfson
Mark
M
Gameroff
Marc J
MJ
Wickramaratne
Priya
P
Pilowsky
Daniel
D
Verdeli
Helen
H
Gross
Raz
R
Manetti-Cusa
Julián
J
Marshall
Randall D
RD
Lantigua
Rafael
R
Shea
Steven
S
Weissman
Myrna M
MM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D003710:Demography; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D016017:Odds Ratio; D011320:Primary Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires