Comparing the Stability of Diagnosis in Full vs. Partial Posttraumatic Stress Disorder

Abstract

We studied differences in diagnostic stability between patients with full and patients with partial posttraumatic stress disorder (PTSD). We collected self-reported symptoms of PTSD, anxiety, depression, and functioning at a Veterans Affairs mental health clinic (n = 1962). We classified patients as meeting full or partial PTSD based upon their initial assessment. We performed Kaplan-Meier survival analysis to compare stability of diagnosis over time and Cox proportional hazards models to understand how comorbid symptoms and level of functioning confounded the relationship. We performed a chart review to examine differences in treatment received by the two groups. Patients in the partial PTSD group lost their diagnosis significantly faster and at significantly higher rates than did patients with full PTSD. Comorbid symptoms contributed significantly to this difference. Mental health treatments delivered to the two groups were similar. These diagnoses appear to be different, suggesting that people with partial PTSD may benefit from a different clinical approach.

Efficacy of Self-Management Smartphone-Based Apps for Post-traumatic Stress Disorder Symptoms: A Systematic Review and Meta-Analysis

“…Evidence-based treatments are available for PTSD (Foa et al, 2009), and guidelines generally recommend exposure therapy and cognitive therapies, and pharmacological treatment as an adjunct treatment (for an overview of psychological treatments see Cusack et al, 2016). Literature on treatment options for subthreshold PTSD is limited (Dickstein et al, 2013), but treatment with lower intensity may be favorable (Shiner et al, 2012;Korte et al, 2016). Many affected individuals, however, remain without treatment due to negative beliefs about efficacy, stigma, logistic reasons, or shortage of qualified treatment centers in the adjacent geographic region (Hoge et al, 2004;Shalev et al, 2011;Kazdin and Rabbitt, 2013).…”

Rates of Subthreshold PTSD Among U.S. Military Veterans and Service Members: A Literature Review

“…Some studies suggests that subthreshold PTSD improves and remits at a higher and faster rate than full PTSD (Blanchard et al, 1997; Shiner et al, 2012), while others find that if left untreated, subthreshold PTSD symptoms can be persistent and worsen over time (Cukor et al, 2010). Among 9/11 World Trade Center disaster recovery workers, about 30% who were classified as having subthreshold PTSD at baseline also met subthreshold or full PTSD criteria one year later, and 25% still were classified as having subthreshold PTSD two years later (Cukor et al, 2010).…”

Examining PTSD treatment choice among individuals with subthreshold PTSD

“…Some evidence suggests that subthreshold PTSD remits at a higher rate than full PTSD following trauma exposure (Blanchard et al, 1997) and that individuals with subthreshold PTSD are more likely to improve at a higher and faster rate than individuals with full PTSD (Shiner et al, 2012). It is difficult to make causal statements surrounding the course of subthreshold PTSD and the extent to which it may remit on its own, however, as neither of the above studies experimentally manipulated or examined potential effects of treatment on symptom remission.…”