PTSD Symptom Severity in VA Primary Care Patients

Session number: 1032

Abstract title: PTSD Symptom Severity in VA Primary Care Patients

Author(s):
KM Magruder - Ralph H. Johnson VA Medical Center and Medical University of South Carolina, Charleston SC
BC Frueh - Ralph H. Johnson VA Medical Center and Medical University of South Carolina, Charleston SC
RG Knapp - Medical University of South Carolina, Charleston SC
MR Johnson - University of Florida, Gainesville FL
D Powell - Dorn VA Medical Center and University of South Carolina, Columbia SC
TC Carson - Ralph H. Johnson VA Medical Center, Charleston SC
G Cain - Ralph H. Johnson VA Medical Center, Charleston SC
S Robert - Medical University of South Carolina, Charleston SC
JA Vaughan III - The Clinical Innovations Group, Charleston SC
R Carter - The Clinical Innovations Group, Charleston SC

Objectives: The objective of this paper is to describe the relationship between PTSD symptoms and selected socio-demographic characteristics among VA primary care patients.

Methods: As part of the ongoing multi-center study "Prevalence and Recognition of PTSD in VA Primary Care Clinics," data were collected on PTSD symptoms, demographic, and clinical characteristics of a random sample of 497 primary care patients from the two VA hospitals in South Carolina (Charleston and Columbia). PTSD symptoms were measured with the PTSD CheckList (PCL), a 17-item self-report instrument that corresponds to the 17 DSMIV PTSD symptoms. We used the recommended cutpoint of 50 to indicate those with a high likelihood for diagnosis of PTSD.

Results: Demographics: average age was 59.8 years; 7.4% female; 39.1% non-white; 53.2% served in the Army; modal education some college or technical school; 66.7% married or living with someone; 1% POW; 37.3% working. 9.5% scored 50+ on the PCL. Considering the relationship of PTSD symptoms (PCL score) and each demographic variable separately, there were significant relationships (odds ratios) between PCL score and age, race, site, and education. Patients <50 years were 5.0 times more likely to have high PCL scores than those 65+; nonwhite patients were 2.1 times more likely to have high PCL scores than white patients; Columbia patients were 1.9 times more likely than Charleston patients; and those with a high school diploma (OR=3.3) or some college (OR=3.5) were more likely than those with less than a high school diploma or those with at least a college degree. In the multivariable model, after adjustment for remaining variables, age and site remained significant; employment status became significant (adjusted OR=2.5 not working relative to working); race and education became nonsignificant.

Conclusions: The findings show that a significant proportion (9.5%) of this large random sample of primary care patients have high levels of PTSD symptoms, with age, employment status, and hospital location as the main associated characteristics. Future analyses will relate these symptoms to an independently determined research diagnosis of PTSD as well as other psychiatric disorders, to medical comorbidities, and health services use patterns.

Impact statement: These findings will help to implement clinical interventions for screening, diagnosing, and treating patients with PTSD in VA primary care settings.