Health status and treatment-seeking stigma in older adults with trauma and posttraumatic stress disorder.
This study compared health status across four trauma/posttraumatic stress disorder (PTSD) groups of older adults with depression, anxiety, and/or at-risk drinking who attended primary care appointments (N = 1,199; mean age = 73.5 yr), mostly at Department of Veterans Affairs hospitals. The trauma and PTSD categories were PTSD (n = 81), partial PTSD (n = 127), trauma only (n = 323), and no trauma (n = 668). Physical and mental health-related quality of life (HQL), indices of social and economic impairment and stigma regarding treatment-seeking were compared among groups. Group differences were found for several indicators of functional impairment; the PTSD group had fewer close friends and higher treatment-seeking stigma beliefs related to having a disorder. Linear mixed modeling examined associations between trauma/PTSD group and HQL. After accounting for covariates, the trauma/PTSD groups differed across the Medical Outcome Study Short Form-36 scales and component scores (indicated by significant group by scale interaction). Differences among groups were confined to mental health measures; those with PTSD had worse HQL. Post hoc analyses examined the number of comorbid psychiatric diagnoses by trauma/PTSD group. Overall, findings indicate that mental HQL varies among older adults with trauma and PTSD and that although treatment-related stigma does not differ among groups, it does affect HQL.
Anica
A
Pless Kaiser
Antonia
A
Seligowski
Avron
A
Spiro
Mohit
M
Chopra
D000368:Aged; D000437:Alcoholism; D001007:Anxiety; D015897:Comorbidity; D003863:Depression; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D011788:Quality of Life; D057545:Social Stigma; D013313:Stress Disorders, Post-Traumatic / Q000534:rehabilitation*; D014728:Veterans
aging; comorbidity; health-related quality of life; linear mixed modeling; mental health; physical health; posttraumatic stress disorder; stigma; trauma; treatment-seeking