Trauma exposure and stress-related disorders in inner city primary care patients.
OBJECTIVE
This study was undertaken to increase understanding of environmental risk factors for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) within an urban, impoverished, population.


METHODS
This study examined the demographic characteristics, patterns of trauma exposure, prevalence of PTSD and MDD, and predictors of posttraumatic stress and depressive symptomatology using a verbally presented survey and structured clinical interviews administered to low-income, primarily African-American (>93%) women and men seeking care in the primary care and obstetrics-gynecology clinics of an urban public hospital.


RESULTS
Of the sample, 87.8% (n=1256) reported some form of significant trauma in their lifetime. Accidents were the most common form of trauma exposure followed by interpersonal violence and sexual assault. Childhood level of trauma and adult level of trauma separately, and in combination, predicted level of adult PTSD and depressive symptomatology. The lifetime prevalence of PTSD was 46.2% and the lifetime prevalence of MDD was 36.7%.


CONCLUSIONS
These data document high levels of childhood and adult trauma exposure, principally interpersonal violence, in a large sample of an inner-city primary care population. Within this group of subjects, PTSD and depression are highly prevalent conditions.
Gillespie
Charles F
CF
Departments of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
Bradley
Bekh
B
Mercer
Kristie
K
Smith
Alicia K
AK
Conneely
Karen
K
Gapen
Mark
M
Weiss
Tamara
T
Schwartz
Ann C
AC
Cubells
Joseph F
JF
Ressler
Kerry J
KJ
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000208:ethnology / Q000706:statistics & numerical data; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000208:ethnology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D017579:Domestic Violence / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D005845:Georgia; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D011902:Rape; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D014505:Urban Population / Q000706:statistics & numerical data*; D014754:Violence / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult