Post-Traumatic Stress Disorder (PTSD): Prevalence and Diagnosis in Outpatient Gynecology
Public Deposited- Last Modified
- January 25, 2020
- Creator
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Meltzer-Brody, Samantha, M.D.
- Affiliation: Gillings School of Global Public Health, Public Health Leadership Program
- Abstract
- Post-traumatic stress disorder (PTSD) is an often debilitating form of anxiety disorder triggered by personal experience of a serious trauma. Women are more than twice as likely as men to develop PTSD. Though one in four women exposed to a traumatic event develops PTSD, no brief tools are available to facilitate identification of PTSD in primary care settings. Our objectives were: 1) to document the prevalence of a history of serious trauma among women seeking routine annual gynecologic care in an academic continuity care setting, and; 2) to evaluate a brief 4-item instrument assessing PTSD symptoms, called the SPAN, as a potential tool for triaging women with a history of trauma for further evaluation. We conducted a cross-sectional survey of English-speaking women scheduled for annual care visits over a 9-month period; and conducted structured clinical interviews as a gold-standard for PTSD diagnosis among a sample of women who reported a history of trauma. The interviewer was blind to SPAN scores. Seventy-six percent of annual care patients (n=292) completed the written survey while waiting for their visit. Ninety women (31%) reported a history of one or more traumatic events including rape, sexual assault, physical assault, and severe motor vehicle accidents. Average age was 34 years, 49% were African American, and 46% were unmarried. Among the 90 women with a history of trauma, 63 agreed to be contacted and we were able to complete the psychiatric assessment for 32. In this convenience sample of 32 women, 25 (78%) met criteria for current PTSD, and 31 of 32 met criteria for other psychiatric comorbidity. Additionally, 68% were not receiving any psychiatric care. Compared to the gold standard for PTSD, SPAN had a sensitivity of 72%, specificity of 74%, positive predictive value of 90% and likelihood ratio of 2.52. Trauma was common in this population. Including a trauma screening question and the SPAN items on written clinic intake surveys has promise for use as a triage tool. Use could meaningfully increase detection of PTSD and other psychiatric morbidity among women receiving routine preventive care.
- Date of publication
- May 2002
- DOI
- Resource type
- Rights statement
- In Copyright
- Note
- Paper type: Research or research design
- Track: HC&P
- Advisor
- Hartmann, Katherine Eubanks
- Degree
- Master of Public Health
- Degree granting institution
- University of North Carolina at Chapel Hill
- Graduation year
- 2002
- Language
- Deposit record
- 564d1737-ca9b-4211-9c3e-c1926665c3df
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