Probable Posttraumatic Stress Disorder and Psychiatric Co-morbidity among Latino Primary Care Patients in Puerto Rico.
Probable Posttraumatic Stress Disorder and Psychiatric Co-morbidity among Latino Primary Care Patients in Puerto Rico.
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DOI：
10.4172/2167-1044.1000124
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发表时间：
2012-12
期刊：
影响因子：
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通讯作者：
Chaplin WF
中科院分区：
文献类型：
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作者：
Vera M;Juarbe D;Hernández N;Obén A;Pérez-Pedrogo C;Chaplin WF
本调查旨在研究波多黎各内城初级保健病人的创伤后应激障碍。具体来说，我们检查了可能的PTSD、PTSD合并MDD和GAD的比率，以及可能的PTSD和合并疾病与人口统计学、治疗和酒精相关因素的关系。我们在主要为低收入患者服务的初级保健实践中筛选了3,568名患者。通过初级保健PTSD筛查、PHQ-9重度抑郁症和GAD Q-IV广泛性焦虑症评估可能存在的PTSD。我们样本中有14%的人可能患有创伤后应激障碍。在该组中，12%的患者符合GAD合并MDD的标准，15.9%的患者符合MDD合并/不合并GAD的标准，而72%的可能患有PTSD的患者不符合合并MDD的标准。超过80%的可能患有创伤后应激障碍的患者表示他们没有接受心理健康治疗。多元logistic回归结果显示，PTSD状态在人口学及酒精相关因素上无显著差异。多项logistic回归分析显示，不同亚组的PTSD患者在心理健康治疗方面存在显著差异。与仅可能患有PTSD的患者相比，可能患有PTSD和重度抑郁症的患者使用心理健康服务的次数要高出4倍，而可能患有PTSD和广泛性焦虑症的患者使用心理健康服务的次数要高出2.5倍。在我们的样本中，可能的PTSD患病率与从部署中返回的士兵和911袭击后的拉丁美洲人的患病率相似。在我们的研究中，内城初级保健患者中可能的PTSD患病率高，而心理健康治疗的使用率低，这突出了未来研究如何有效地针对和治疗需要治疗PTSD的拉丁裔初级保健患者的需要。
The present investigation was designed to study PTSD among inner city primary care patients in Puerto Rico. Specifically, we examined the rate of probable PTSD, PTSD co-morbidity with MDD and GAD, and the association of probable PTSD and co-occurring disorders with demographic, treatment, and alcohol related factors. We screened 3,568 patients at primary care practices serving primarily low-income patients. The presence of probable PTSD was assessed with the Primary Care PTSD screen, major depression with the PHQ-9, and generalized anxiety disorder with the GAD Q-IV. Fourteen percent of our sample screened positive for probable PTSD. Among this group, 12% met criteria for co-morbid GAD without MDD and 15.9% for co-morbid MDD with/without GAD, whereas 72% of the patients with probable PTSD did not meet criteria for co-morbidity. Over 80% of the patients with probable PTSD indicated they were not receiving mental health treatment. Multiple logistic regression findings show that there were no significant differences in demographic and alcohol related factors by PTSD status. Multinomial logistic regression analysis revealed significant differences in the use of mental health treatment among the subgroups of patients with probable PTSD. As compared to patients with only probable PTSD, the use of mental health services was 4 times higher among patients with probable PTSD and MDD and over 2 1/2 times higher among patients with probable PTSD and GAD. The prevalence rate of probable PTSD in our sample was similar to the rates reported for soldiers after returning from deployment and for Latinos after the September 11 attacks. The high prevalence of probable PTSD and low use of mental health treatment among inner city primary care patients in our study, highlight the need of future research to obtain information on how to effectively target and treat Latino primary care patients in need of treatment for PTSD.