title: Correlates of utilization of PTSD specialty treatment among recently diagnosed veterans at the VA.
abstract: OBJECTIVE
  This study described utilization of specialty treatment for posttraumatic stress disorder (PTSD) at U.S. Department of Veterans Affairs (VA) facilities among veterans of Operation Enduring Freedom (OEF), in Afghanistan, or of Operation Iraqi Freedom (OIF), in Iraq, and non-OEF-OIF veterans recently diagnosed as having PTSD. It also identified predictors of receiving minimally adequate specialty treatment, defined as attending at least nine clinic visits within 365 days of screening positive for PTSD.
  
  
  METHODS
  VA administrative data were obtained for 869 veterans who screened positive for PTSD between November 7, 2006, and September 30, 2008, received a diagnosis of PTSD, and visited a PTSD specialty clinic operated by the VA in the Pacific Northwest at least once within a year of screening positive.
  
  
  RESULTS
  A total of 286 (33%) of the 852 veterans for whom complete data were available received minimally adequate specialty treatment; OEF-OIF veterans were less likely than non-OEF-OIF veterans to receive minimally adequate specialty treatment (29% versus 36%, p=.021) and attended fewer mean±SD visits to a PTSD clinic (8.2±11.4 versus 9.9±13.5, p=.045). Predictors of receiving minimally adequate specialty treatment included attending a PTSD clinic visit within 30 days of a positive screen, living in an urban location, and having psychiatric comorbidities.
  
  
  CONCLUSIONS
  Most veterans with new PTSD diagnoses who initiated VA PTSD specialty care did not receive minimally adequate specialty treatment. Future studies should examine factors that lead to premature discontinuation of PTSD treatment and to what extent specialty treatment for PTSD is necessary.
authors.affiliation: Mental Health and Neurosciences Division, Portland VA Medical Center, 3710 SW US Veterans Hospital Rd., Portland, OR 97239, USA. mary.lu@va.gov
authors.forename: Mary W
authors.initials: MW
authors.lastname: Lu
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Duckart
authors.forename: Jean P
authors.initials: JP
authors.lastname: O'Malley
authors.forename: Steven K
authors.initials: SK
authors.lastname: Dobscha
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000628:therapy*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data*; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*