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Abstract
BackgroundThe 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.MethodsWe 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.ResultsFourteen 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.ConclusionThe 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.
Highlights
Posttraumatic Stress Disorder (PTSD) is a disabling anxiety disorder that may develop after exposure to an overwhelming traumatic event
Findings from studies conducted after terrorist attacks [8,9,10], physical injury [11], police work [12,13], natural disasters [14], and military combat [15] suggest that Latinos in the United States (US) are at more risk for PTSD than their white and African American counterparts
A representative survey conducted in New York City in the aftermath of the September 11 attacks showed that the prevalence of probable PTSD was higher among Dominicans (14.3%) and Puerto Ricans (13.2%) than among other Latinos (6.1%) [9]
Summary
Posttraumatic Stress Disorder (PTSD) is a disabling anxiety disorder that may develop after exposure to an overwhelming traumatic event. Puerto Ricans seem to be more vulnerable to PTSD than other Latino groups. Ortega and Rosenheck [16] reexamined data on Vietnam War veterans to explore PTSD among specific Latino subgroups. They found that Puerto Rican veterans had a higher probability of having PTSD than other Latino veterans. A representative survey conducted in New York City in the aftermath of the September 11 attacks showed that the prevalence of probable PTSD was higher among Dominicans (14.3%) and Puerto Ricans (13.2%) than among other Latinos (6.1%) [9]. 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
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