NEW YORK — Primary care patients should be screened for trauma and posttraumatic stress disorder when they first come in, Tanya Alim, M.D., of Howard University, Washington, said in a poster presentation at the annual meeting of the American Psychiatric Association.
Dr. Alim and her colleagues surveyed 360 primary care patients in waiting rooms at three primary care offices at a Washington hospital; 98% of the subjects were African American. Patients were given a questionnaire to assess their level of trauma exposure. The survey also asked about drug and alcohol use. Patients were compensated for their time. Those who mentioned having been exposed to some form of severe or life-threatening trauma were asked to go to the hospital's outpatient mental health clinic to undergo an interview and complete more questions on coping and stress.
The researchers found that 69% of subjects had been exposed to one or more traumatic situations, including both community- and family-based events. Women were more likely to have experienced a sexual assault; men were more likely to have been exposed to physical assault and assault with a weapon.
In addition to trauma exposure, the authors found high rates of posttraumatic stress disorder in the study population. Both male and female victims of sexual assault were found to be at higher risk of developing posttraumatic stress disorder.
“Everyone should be sensitive to asking about trauma,” said Dr. Alim, clinical director of the mood and anxiety program at Howard University Hospital. “People presenting with medical problems in a primary care setting appear to be more likely to have a history of previous trauma. Primary care doctors need to be sensitive to that type of information.”
She added that patients with a history of trauma might be at greater risk of experiencing another traumatic incident, compared with those who have not experienced trauma.