title: PTSD treatment of African American adults in primary care: the gap between current practice and evidence-based treatment guidelines.
abstract: BACKGROUND
  Posttraumatic stress disorder (PTSD) is a common, potentially disabling, underdiagnosed, and under-treated illness. Primary care physicians assume a critical role in the diagnosis, treatment, and referral of African Americans with PTSD since mental health access is limited for this population. This study is an examination of PTSD treatment of African Americans in the primary care setting. Actual treatment provision is contrasted with existing evidence-based PTSD treatment guidelines.
  
  
  METHODS
  Researchers screened 738 consenting, mostly African American, adults in 4 academically affiliated primary care offices for both trauma exposure and mental health symptoms, including PTSD.
  
  
  RESULTS
  Employing criteria from the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) (DSM-IV), investigators diagnosed 91 of the participants with current PTSD using the Structured Clinical Interview for DSM and the clinician-administered of PTSD Scale for DSM-IV. Treatment statistics include: 69.2% (n=63) had never received treatment from a mental health provider: 18.6% (n=17) were currently seeing a mental health practitioner; nearly half (47.9%, n=24) of a subsample had never discussed traumatic event exposure or mental health symptoms with their primary care doctor; 32% (n=29) were prescribed psychotropic medication and only 18.6% (n=17) were participating in any form of psychotherapy. Concurrent psychiatric disorders were found in 46.2% (n = 42) of the participants with PTSD.
  
  
  CONCLUSIONS
  Most African American adult primary care patients with PTSD were either undiagnosed or undertreated in this inner-city setting. These results demonstrate a clear need to improve screening and treatment services. Both individual (provider and patient) and system-based changes will be required to meet the demonstrated clinical need.
authors: Department of Community and Family Medicine, Howard University, Washington, DC 20060, USA. RevElaineGraves@att.net
authors: Ruth Elaine
authors: RE
authors: Graves
authors: John R
authors: JR
authors: Freedy
authors: Notalelomwan U
authors: NU
authors: Aigbogun
authors: William B
authors: WB
authors: Lawson
authors: Thomas A
authors: TA
authors: Mellman
authors: Tanya N
authors: TN
authors: Alim
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People; D004219:District of Columbia; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D011613:Psychotherapy / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000628:therapy*; D001741:Black or African American
chemical_list: D011619:Psychotropic Drugs