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Trauma and Posttraumatic Stress Disorder in the Elderly: Findings From a German Community Study

J Clin Psychiatry 2008;69(5):693-700

Objective: The present study assessed the risk of trauma exposure and subsequent posttraumatic stress disorder (PTSD) in an elderly community sample. Furthermore, gender differences and psychiatric comorbidity were analyzed.

Method: 3170 adults living in a German community were assessed by the PTSD module of the Structured Clinical Interview for DSM-IV and the Composite International Diagnostic-Screener. They were assigned to 3 age groups: young (44 years and younger; N = 997), middle-aged (45-64 years; N = 1322), and elderly (65 years and older; N = 851). Data for the present study were collected between December 2002 and December 2006.

Results: At least 1 trauma was reported by 54.6%, and the odds for trauma exposure were almost 4-fold in the elderly compared to the younger age groups (OR = 3.74; 95% CI = 3.13 to 4.47). Among those traumatized, the lifetime and 1-month prevalence rates of PTSD in the elderly were 3.1% and 1.5%, respectively, and did not differ from the rates of the young and middle-aged adults. Elderly men had a significantly increased risk for trauma exposure in general than elderly women (p = .012), but there were no gender differences in PTSD prevalence rates. Elderly PTSD-positive participants had significantly higher odds for any psychiatric syndrome than those without PTSD (OR = 9.10; 95% CI = 2.64 to 31.28) with depression and anxiety being the most frequent conditions.

Conclusion: Our findings suggest that PTSD is certainly not rare in the elderly and that a lifetime diagnosis of PTSD is associated with symptoms of depression and anxiety. Assessment of trauma and PTSD should be integrated into routine examinations of the elderly to improve management and treatment provisions.