Duloxetine in the Long-Term Treatment of Major Depressive Disorder
J Clin Psychiatry 2003;64(10):1230-1236
© Copyright 2017 Physicians Postgraduate Press, Inc.
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Background: Posttraumatic stress disorder (PTSD)
is receiving growing attention as a pervasive and impairing
disorder but is still undertreated. Our purpose was to describe
the characteristics of mental health treatment received by
primary care patients diagnosed with PTSD.
Method: 4383 patients from 15 primary care,
family practice, or internal medicine clinics were screened for
anxiety symptoms using a self-report questionnaire developed for
the study. Those found positive for anxiety symptoms (N = 539)
were interviewed with the Structured Clinical Interview for
DSM-IV. Of these patients, 197 met diagnostic criteria for PTSD
and were examined in the present study regarding the rates and
types of mental health treatment they were currently receiving.
Data were gathered from July 1997 to May 2001.
Results: Nearly half (48%) of the patients in
general medical practice with PTSD were receiving no mental
health treatment at the time of intake to the study. Of those
receiving treatment, psychopharmacologic interventions were most
common. Few patients were receiving empirically supported
psychosocial interventions. Current comorbid major depressive
disorder and current comorbid panic disorder with agoraphobia
were significantly associated with receiving mental health
treatment (major depressive disorder, p < .10; panic disorder
with agoraphobia, p < .05). The most common reason patients
gave for not receiving medication was the failure of physicians
to recommend such treatment, which was also among the most common
reasons for not receiving psychosocial treatment.
Conclusions: Despite the morbidity, psychosocial
impairment, and distress associated with PTSD, substantial
proportions of primary care patients with the disorder are going
untreated or are receiving inadequate treatment. Results suggest
a need for better identification and treatment of PTSD in the
primary care setting.