title: [Correlation between specific and nonspecific posttraumatic stress disorder symptoms with healthcare consumption among 340 French soldiers].
abstract: BACKGROUND
  The psychotraumatic disorders are often difficult to diagnose because the specific symptoms of posttraumatic stress disorder (revival, hyperarousal, avoidance) are rarely a direct demand for health care: for reasons determined by the psychopathological structure of trauma, its symptomatology and course, the psychotraumatised subjects seek a care system for nonspecific psychological or somatoform symptoms: depressive episode, cognitive disorders, other anxiety disorders, histrionic and obsessive symptoms, changes in personality, pain disorders and somatization. Somatic pain may also result from a war injury and psychosomatic complications, addictive or consequences of risk behaviours during the evolution of posttraumatic stress disorder.
  
  
  OBJECTIVE
  To establish a correlation between the PCLS and the evaluation of the healthcare consumption in a military population.
  
  
  METHODS
  We conducted a multicenter epidemiological study analyzing the PCLS and a questionnaire assessing health care consumption. The PCLS has been studied in various forms: quantitative (17 to 85), in qualitative classes (<33, 33 to 43 and ≥44), and in five sub-dimensions (flashbacks, avoidance, dissociation, depression and hyperactivity). The sub-dimension revival was then studied item by item. The criteria used care consumption over the last twelve months is the numbers of days of sick leave, days of unavailability (of certain jobs or military activities) and consultations.
  
  
  RESULTS
  Our population of 340 subjects cannot be considered representative of the French military population even if only a few characteristics differ. Sixteen of 340 subjects show a positive PCLS is 4.70% of our sample. PCLS average of 23 (±9.4) with a median of 19 objectifying much of PCLS have almost zero score. Validating our main hypothesis, we found a statistically significant relationship between elements of the PCLS and variables care consumption: this link exists mainly between the score, classes and sub-dimensions of the PCLS in one hand and number of days of sick leave and unavailability on the other hand.
  
  
  CONCLUSIONS
  Towards a strategy for tracking psychotraumatic disorders, could be developed a score of health care consumption which would include the number of days of sick leave and unavailability, the number and quality of medical consultations, the number and quality of drug and laboratory requirements, the number of hospitalisations. To the identification of posttraumatic stress disorder, the PCLS score as well as the consumer healthcare score are valuable tools but do not replace the subjectivity of the clinical relationship: return to this shared subjectivity with the practitioner remains a diagnostic dimension, but also therapeutic, fundamental.
authors.affiliation: Direction régionale du service de santé des armées en région Nord-Est, caserne Ney, 1, rue du Maréchal-Lyautey, CS 30001, 57044 Metz cedex 1, France.
authors.forename: L
authors.initials: L
authors.lastname: Holterbach
authors.affiliation: Direction régionale du service de santé des armées en région Nord-Est, caserne Ney, 1, rue du Maréchal-Lyautey, CS 30001, 57044 Metz cedex 1, France.
authors.forename: C
authors.initials: C
authors.lastname: Baumann
authors.affiliation: Direction régionale du service de santé des armées en région Nord-Est, caserne Ney, 1, rue du Maréchal-Lyautey, CS 30001, 57044 Metz cedex 1, France.
authors.forename: B
authors.initials: B
authors.lastname: Andreani
authors.affiliation: Direction régionale du service de santé des armées en région Nord-Est, caserne Ney, 1, rue du Maréchal-Lyautey, CS 30001, 57044 Metz cedex 1, France.
authors.forename: D
authors.initials: D
authors.lastname: Desré
authors.affiliation: HIA Percy, 101, avenue Henri-Barbusse, BP 406, 92140 Clamart, France. Electronic address: yann.auxemery@hotmail.fr.
authors.forename: Y
authors.initials: Y
authors.lastname: Auxéméry
mesh_terms: D000328:Adult; D005260:Female; D005602:France / Q000453:epidemiology; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data*; D010146:Pain / Q000209:etiology; D012017:Referral and Consultation; D012309:Risk-Taking; D018582:Sick Leave / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Army; Armées; Consommation de soins; Detection; Dépistage; Epidemiology; Healthcare consumption; Militaires; PCLS; Posttraumatic stress disorder; Psychopathologie; Psychopathology; Soldiers; Épidémiologie; État de stress post-traumatique