title: Trauma exposure and stress-related disorders in inner city primary care patients.
abstract: 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.
authors.affiliation: Departments of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Gillespie
authors.forename: Bekh
authors.initials: B
authors.lastname: Bradley
authors.forename: Kristie
authors.initials: K
authors.lastname: Mercer
authors.forename: Alicia K
authors.initials: AK
authors.lastname: Smith
authors.forename: Karen
authors.initials: K
authors.lastname: Conneely
authors.forename: Mark
authors.initials: M
authors.lastname: Gapen
authors.forename: Tamara
authors.initials: T
authors.lastname: Weiss
authors.forename: Ann C
authors.initials: AC
authors.lastname: Schwartz
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Cubells
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Ressler
mesh_terms: 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