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Exposure to Trauma and Posttraumatic Stress Disorder Symptoms in Older Veterans Attending Primary Care: Comorbid Conditions and Self-Rated Health Status

Authors

  • U. Nalla B. Durai MD,

    1. From the Department of Psychiatry, Jesse Brown VA Medical Center
    2. Department of Psychiatry, School of Medicine, University of Illinois, Chicago, Illinois
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  • Mohit P. Chopra MD,

    1. Department of Psychiatry, Veterans Affairs Boston Healthcare System, Boston, Massachusetts
    2. Department of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts
    3. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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  • Eugenie Coakley MA, MPH,

    1. John Snow, Inc., Boston, Massachusetts
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  • Maria D. Llorente MD,

    1. Department of Mental Health, Washington DC Veterans Affairs Medical Center, Washington, District of Columbia
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  • JoAnn E. Kirchner MD,

    1. VA Mental Health Quality Enhancement Research Initiative, Central Arkansas Veteran's Healthcare System
    2. Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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  • Joan M. Cook PhD,

    1. Department of Psychiatry, Yale School of Medicine and National Center for PTSD, New Haven, Connecticut;
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  • Sue E. Levkoff ScD, SM, MSW

    1. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
    2. College of Social Work, University of South Carolina, Columbia, South Carolina.
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  • Presented in part at the 16th annual meeting of the American Association for Geriatric Psychiatry, Honolulu, Hawaii, March 2003.

  • U. Nalla B. Durai and Mohit P. Chopra share joint first authorship for this article.

Address correspondence to Mohit P. Chopra, Geriatric Mental Health, 35C, 940 Belmont Street, Brockton, MA 02301. E-mail:mpchopra@hotmail.com; Mohit.chopra@va.gov

Abstract

OBJECTIVES: Assess the prevalence of posttraumatic stress disorder (PTSD) symptomatology and its association with health characteristics in a geriatric primary care population.

DESIGN: Cross-sectional screening assessments during a multisite trial for the treatment of depression, anxiety, and at-risk drinking.

SETTING: Department of Veterans Affairs (VA)-based primary care clinics across the United States.

PARTICIPANTS: Seventeen thousand two hundred five veterans aged 65 and older.

MEASUREMENTS: Sociodemographic information, the General Health Questionnaire (GHQ-12), questions about death wishes and suicidal ideation, quantity and frequency of alcohol use, smoking, exposure to traumatic events, and PTSD symptom clusters.

RESULTS: Twelve percent (2,041/17,205) of participants screened endorsed PTSD symptoms. Veterans with PTSD symptoms from some (partial PTSD) or each (PTSD all clusters) of the symptom clusters were significantly more likely to report poor general health, currently smoke, be divorced, report little or no social support, and have a higher prevalence of mental distress, death wishes, and suicidal ideation than those with no trauma history or those with trauma but no symptoms. Group differences were most pronounced for mental distress and least for at-risk drinking. Presence of PTSD all clusters was associated with poorer outcomes on all of the above-mentioned health characteristics than partial PTSD.

CONCLUSION: PTSD symptoms are common in a substantial minority of older veterans in primary care, and careful inquiry about these symptoms is important for comprehensive assessment in geriatric populations.

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