How to Prioritize PTSD Screening in Underrecognized Adult Populations
How should clinicians prioritize PTSD case-finding in adult populations that carry substantial but underrecognized burden?
Adults with PTSD are often underdiagnosed and untreated despite substantial clinical and economic burden. This article highlights that most PTSD burden in the United States falls in civilians rather than military populations, and that women account for a disproportionate share of affected adults, making targeted awareness and screening especially relevant in routine care.
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Recognize civilians as the largest affected group
Do not limit PTSD case-finding to combat-exposed or military patients. The article estimates that 81.6% of total excess PTSD costs occurred in the civilian population and notes that 86% of people with PTSD were in civilian groups, indicating that civilian settings are major sites for detection.
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Give added attention to women with trauma exposure or compatible symptoms
Maintain a lower threshold for considering PTSD in women, particularly in civilian practice. Female adults accounted for 66.4% of the overall PTSD population in the analysis, and the discussion emphasizes sexual assault and domestic violence as important areas for prevention and intervention.
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Use low-training screening tools in primary care and community settings
Increase use of PTSD screening tools that require little clinical training and can be made available online, especially in primary care and community practice. The article explicitly states that primary care providers and community providers may benefit from increased cognizance of such tools to improve identification.
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Link positive identification to active treatment discussion
When PTSD is identified, move beyond recognition to treatment engagement because underdiagnosis and non-treatment contribute to ongoing burden. The article notes that many individuals remain untreated, that stigma impedes care seeking, and that expanding access to treatment is warranted.
Clinical Considerations
- The article does not name a specific screening instrument or provide a validated screening algorithm.
- The paper is an economic burden analysis, so its support for screening is based on the scale of unmet need rather than direct testing of a screening program.
- PTSD prevalence estimates used in the analysis were based on a narrow definition of PTSD and may underestimate the affected population.
Bottom Line
Clinicians should broaden PTSD case-finding beyond military populations and actively prioritize screening in civilian adults, especially women, because that is where most of the burden lies.
