PTSD in mental health outpatient settings: highly prevalent and under-recognized

Silva, Herika C da; Rosa, Maísa M Furtado da; Berger, William; Luz, Mariana Pires; Mendlowicz, Mauro V.; Coutinho, Evandro Silva Freire; Portella, Carla Marques; Marques, Pamela I. S; Mograbi, Daniel C.; Figueira, Ivan; Ventura, Paula

doi:10.1590/1516-4446-2017-0025

Cited by 22 publications

(16 citation statements)

References 43 publications

(49 reference statements)

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“…Our results correspond well with findings from a similar study in Norway which found PTSD rate around 89% in the trauma affected patients seeking help in a psychiatric clinic [42]. Studies done in hospitals or outpatient settings have found a wide range of prevalence of PTSD, ranging from 11.2% to 69% [31,43,44]. Similar rates have been seen in conflict-affected settings in Nepal and internationally [24,26].…”

Section: Plos Onesupporting

confidence: 91%

“…Thus both clinicians and patients themselves may be blind to the possibility of having PTSD. This trend is found in other parts of the world as well [31,51].…”

Section: Plos Onesupporting

confidence: 65%

“…It has been established that neglecting and not treating PTSD can make it chronic, more severe, and highly incapacitating [30]. Furthermore, inquiring about traumatic life events as well as assessing for PTSD in the clinical setting is also less commonly practiced in many parts of the world [31].…”

Section: Introductionmentioning

confidence: 99%

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Trauma related psychiatric disorders and their correlates in a clinical sample: A cross-sectional study in trauma affected patients visiting a psychiatric clinic in Nepal

et al. 2020

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Background Nepal, like many other low-income countries, has a great burden of mental health issues but few resources to meet them. In addition, Nepal has endured several traumatic events in recent decades but the impact on mental health has not been studied in clinical settings. This study explores trauma-related psychiatric disorders and their correlates. Methods 100 patients with a history of trauma who visited the outpatient psychiatry clinic at a University hospital in Kathmandu were assessed. The Composite International Diagnostic Interview 2.1 (CIDI) was used to evaluate lifetime and current depressive disorder, generalized anxiety disorder (GAD) and lifetime post-traumatic stress disorder (PTSD). Current PTSD was evaluated using PSTD Checklist-Civilian Version (PCL-C). Results The median number of lifetime traumatic events was two. Natural disaster was the most common trauma type (84%) compared to other types of trauma. Rape was reported as the most traumatizing. Current PTSD was found in 15%, depression in 33% and GAD in 38% of the patients. The lifetime rates were PTSD 83%, depression 45% and GAD 40%. There was high comorbidity between the disorders. The 31 to 45 years age group, above high school education level and trauma types other than earthquake were independently associated with current PTSD. Marital status and upper socioeconomic status (SES) compared to upper-middle SES were independently associated with lifetime PTSD. Both lifetime and current depression rates were independently associated with the upper SES compared to

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Section: Plos Onesupporting

confidence: 91%

“…Thus both clinicians and patients themselves may be blind to the possibility of having PTSD. This trend is found in other parts of the world as well [31,51].…”

Section: Plos Onesupporting

confidence: 65%

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Trauma related psychiatric disorders and their correlates in a clinical sample: A cross-sectional study in trauma affected patients visiting a psychiatric clinic in Nepal

et al. 2020

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“…As described in more details in the case report itself, a missed diagnosis of PTSD has many dire consequences: unnecessarily prolonged suffering, suicidality, family stress, stigmatization, increased risk of domestic violence, loss of income, among others. The small literature available suggests that these cases are not rare 5 and the present report may help us identify some factors contributing to this phenomenon.…”

Section: Discussionmentioning

confidence: 69%

“…A recent study in a Brazilian university psychiatric outpatient clinic found that forty-one individuals (20.5%) out of 200 patients were suffering from current PTSD, but only one of them (2.4%) had this diagnosis recorded in his medical file. This study indicated that although PTSD may be highly prevalent among psychiatric outpatients, it is underdiagnosed even in teaching hospitals 5 which are reputed to provide high-quality care 6 .…”

Section: Introductionmentioning

confidence: 86%

Unnecessarily prolonged suffering: a case of missed diagnosis of post-traumatic stress disorder in a teaching hospital

Oliveira

Mendlowicz

Berger

et al. 2021

J. bras. psiquiatr.

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We described a case in which a heavily-traumatized patient had been under psychiatric treatment for seven years (five of them in a university mental health clinic) but was never diagnosed with PTSD and, therefore, did not receive the proper treatment for a very long period. After the correct diagnosis was made and personalized treatment instituted, the patient has shown marked improvement in functionality and wellbeing. The key element in this case, was the adequacy of psychiatric training. Our report suggests that psychiatrists are not being adequately trained to identify traumatic events and to diagnose atypical cases of PTSD. With that in mind, we emphasize that theoretical modules on trauma and trauma-related disorders and practical training in specialized PTSD clinics should be incorporated into the psychiatric residency training programs wherever they may be missing, particularly in countries most impacted by violence. Furthermore, continuing medical education on trauma and PTSD should be provided by medical associations and journals to keep physicians updated on recent progress in the field.

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Sensitivity and specificity of the Posttraumatic Stress Disorder Checklist for DSM‐5 in a Canadian psychiatric outpatient sample

Boyd

Cameron

Shnaider

et al. 2021

Journal of Traumatic Stress

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The Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) is a widely used, self-report measure that is employed to assess PTSD symptom severity and determine the presence of probable PTSD in various trauma-exposed populations. The PCL-5 is often administered in clinical settings as a screening tool for PTSD, with a suggested cutoff score of 33 indicating a probable PTSD diagnosis. Recent research indicates that a higher cutoff may be required in psychiatric samples. In the present study, we aimed to determine the sensitivity and specificity of the PCL-5 in a Canadian outpatient psychiatric sample and establish an optimal cutoff score for detecting probable PTSD in this sample. Participants were 673 individuals who reported a history of trauma exposure and were assessed using a semistructured interview and self-report measures. Individuals diagnosed with PTSD (N = 193) reported a mean PCL-5 score of 56.57, whereas individuals without PTSD (N = 480) reported a mean score of 33.56. A score of 45 was determined to be the optimal cutoff score in this sample, balancing sensitivity and specificity while detecting a probable diagnosis of PTSD. Consistent with 424

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PTSD in mental health outpatient settings: highly prevalent and under-recognized

Cited by 22 publications

References 43 publications

Trauma related psychiatric disorders and their correlates in a clinical sample: A cross-sectional study in trauma affected patients visiting a psychiatric clinic in Nepal

Trauma related psychiatric disorders and their correlates in a clinical sample: A cross-sectional study in trauma affected patients visiting a psychiatric clinic in Nepal

Unnecessarily prolonged suffering: a case of missed diagnosis of post-traumatic stress disorder in a teaching hospital

Sensitivity and specificity of the Posttraumatic Stress Disorder Checklist for DSM‐5 in a Canadian psychiatric outpatient sample

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