title: Discrepancy in diagnosis and treatment of post-traumatic stress disorder (PTSD): treatment for the wrong reason.
abstract: In primary care (PC), patients with post-traumatic stress disorder (PTSD) are often undiagnosed. To determine variables associated with treatment, this cross-sectional study assessed 592 adult patients for PTSD. Electronic medical record (EMR) review of the prior 12 months assessed mental health (MH) diagnoses and MH treatments [selective serotonin reuptake inhibitor (SSRI) and/or ≥1 visit with MH professional]. Of 133 adults with PTSD, half (49%; 66/133) received an SSRI (18%), a visit with MH professional (14%), or both (17%). Of those treated, 88% (58/66) had an EMR MH diagnosis, the majority (71%; 47/66) depression and (18%; 12/66) PTSD. The odds of receiving MH treatment were increased 8.2 times (95% CI 3.1-21.5) for patients with an EMR MH diagnosis. Nearly 50% of patients with PTSD received MH treatment, yet few had this diagnosis documented. Treatment was likely due to overlap in the management of PTSD and other mental illnesses.
authors.affiliation: Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, USA.
authors.forename: Ellen C
authors.initials: EC
authors.lastname: Meltzer
authors.forename: Tali
authors.initials: T
authors.lastname: Averbuch
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
authors.forename: Richard
authors.initials: R
authors.lastname: Saitz
authors.forename: Khelda
authors.initials: K
authors.lastname: Jabbar
authors.forename: Christine
authors.initials: C
authors.lastname: Lloyd-Travaglini
authors.forename: Jane M
authors.initials: JM
authors.lastname: Liebschutz
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003951:Diagnostic Errors; D057286:Electronic Health Records; D005260:Female; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011613:Psychotherapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014505:Urban Population
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors
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