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PTSD associated with more severe psychiatric symptoms, less service use

Data from PTSD screenings and electronic medical records showed that patients with probable PTSD reported more severe psychiatric symptoms and were less likely to receive treatment, according to a study published in Psychiatric Services.

“PTSD screening is feasible and recommended in service environments and may contribute significantly to better understanding of racial-ethnic and other differences in service use and diagnostic practices,” Shula K. Minsky, EdD, from the department of quality improvement at Rutgers Behavioral Health Care and the department of psychiatry at Rutgers University, and colleagues wrote.

Researchers examined PTSD screening data and Behavior and Symptom Identification Scale (BASIS-24 [41]) scores for 1,834 patients (1,048 women, 786 men) active at Rutgers University Behavioral Health Care between January 2007 and November 2010. The researchers also collected data on services provided 1 year before and 1 year after PTSD screening.

Approximately half of patients (49%; 56% of whom were male) were recognized as having probable PTSD based on their screening score (≥ 45), according to the results.

After controlling for diagnosis, race-ethnicity, age and gender, results from six regression analyses (one for each BASIS-24 domain score) demonstrated that patients with probable PTSD had more severe symptoms of depression, interpersonal issues, self-harm, emotional liability, psychosis and substance abuse (P < .001). Additionally, black patients with probable PTSD reported more severe symptoms — especially psychosis (P < .001) — than black patients without probable PTSD and all white patients.

“Because a subset of PTSD symptoms overlaps with psychiatric symptoms, the study suggests the importance of carefully assessing traumatic history and symptoms before making a diagnosis of psychiatric disorders, particularly schizophrenia,” Minsky and colleagues wrote.

In terms of service use, those with probable PTSD used less partial-hospitalization services and were more likely to miss outpatient and partial-hospitalization appointments, compared with those without probable PTSD (P < .001).

“It is not clear whether this finding was due to the clients’ own choice or the inability of the system to provide services that are appropriate for clients with trauma and PTSD in addition to their serious mental illness,” Minsky and colleagues wrote. – by Stephanie Viguers

Disclosure: The researchers report no relevant financial disclosures.