Traumatic events and mental health in civilian primary care: implications for training and practice

Fam Med. 2010 Mar;42(3):185-92.

Abstract

Background and objectives: Primary care research into post-traumatic stress disorder (PTSD) is less developed than primary care depression research. This study documents lifetime traumatic events and past month depression and PTSD in adult patients of a large family medicine residency practice.

Methods: We used a telephone survey of 411 adult patients from a family medicine residency practice in the Southeastern United States. Standardized measures were used.

Results: Seventy-nine percent of study enrollees completed the study. Women were significantly more likely than men to have been diagnosed with PTSD (35.8% versus 20.0%) or depression (36.1% versus 21.1%), with a high degree of diagnosis overlap (76.5%). Most adults (>90%) reported one or more traumatic events. Men reported more war zone/combat events; women reported more sexual victimization. More than 80% of patients thought family physicians should ask about traumatic events; only a minority recalled being asked (26.8% men, 43.6% women). Regression models determined that current depression and several traumatic events were significant correlates of current PTSD.

Conclusions: Key gender differences in frequency of lifetime traumatic events, past month depression and PTSD, and patient attitudes about trauma questions existed. Current PTSD was best predicted by a combination of coexisting depression and traumatic events. Discussion explores training and practice implications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Data Collection
  • Depression / epidemiology*
  • Depression / etiology
  • Female
  • Humans
  • Logistic Models
  • Male
  • Mental Health*
  • Middle Aged
  • Multivariate Analysis
  • Primary Health Care*
  • Psychometrics
  • Risk Factors
  • Sex Factors
  • South Carolina / epidemiology
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / etiology
  • Stress, Psychological / complications*
  • Surveys and Questionnaires
  • United States / epidemiology
  • Wounds and Injuries*
  • Young Adult