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Posttraumatic Stress Disorder and the Use of Health Services

 

作者: Eva Deykin,   Terence Keane,   Danny Kaloupek,   Graeme Fincke,   James Rothendler,   Melissa Siegfried,   Kent Creamer,  

 

期刊: Psychosomatic Medicine  (OVID Available online 2001)
卷期: Volume 63, issue 5  

页码: 835-841

 

ISSN:0033-3174

 

年代: 2001

 

出版商: OVID

 

关键词: Posttraumatic stress disorder;primary care;health services utilization;veterans;health status

 

数据来源: OVID

 

摘要:

ObjectivePrior research has demonstrated increased use of medical services among persons with anxiety and depression. This investigation examined the possible association of posttraumatic stress disorder (PTSD) with the use of nonmental health services.MethodA case-comparison design enrolled 102 high users of health services and 54 low users who were assessed for PTSD diagnosis and severity of PTSD symptoms. Subjects were male veterans receiving services from the primary care clinics of the VA Boston Healthcare System during an 18-month period. Data were collected by interview by use of standardized instruments including the Clinician Administered PTSD Scale for DSM-IV, the Life Events Checklist, and the Beck Depression Inventory. Data analysis employed odds ratios, linear and logistic regression, and path analyses.ResultsHigh users of health care were almost twice as likely as low users (27.5% vs. 14.8%) to meet diagnostic criteria for current PTSD. The two groups differed significantly on both symptom frequency and intensity. Path analyses showed an indirect positive association between PTSD and health services use, with physician-diagnosed health conditions as a mediating variable. Auxiliary analysis demonstrated that the combined mental health burden of PTSD and depression symptoms also is positively associated with number of health conditions.ConclusionsThe findings indicate that PTSD, alone and in combination with depression, has a direct negative relationship with physical health that, in turn, is associated with more frequent use of primary health care services. These results do not suggest that PTSD leads to inappropriate (eg, distress-motivated) use of services.

 

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