Undetected post-traumatic stress disorder in secondary-care mental health services: systematic review

Zammit, Stanley; Lewis, Catrin; Dawson, Sarah; Colley, Hannah; McCann, Hannah; Piekarski, Alice; Rockliff, Helen; Bisson, Jonathan I.

doi:10.1192/bjp.2017.8

Cited by 42 publications

(43 citation statements)

References 52 publications

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“…Patients with a positive PC-PTSD result may also have met the full diagnostic criteria for PTSD, which had not been detected until the time of screening. 43 As a consequence, in lieu of waiting for a formal diagnosis, it may be important to consider initiating suicide risk assessment strategies for patients with positive responses on the PC-PTSD. Another reason to use and incorporate the PC-PTSD into suicide risk assessment strategies is that, unlike a medical records diagnosis, the PC-PTSD asks a patient about PTSD symptoms experienced within the past month.…”

Section: Discussionmentioning

confidence: 99%

Association Between Positive Results on the Primary Care–Posttraumatic Stress Disorder Screen and Suicide Mortality Among US Veterans

et al. 2020

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Key Points Question Are positive results on the Primary Care–Posttraumatic Stress Disorder Screen associated with an increase in the risk of suicide mortality among veterans receiving care in the US Veterans Health Administration system and, if so, does this risk decrease over time? Findings In this cohort study of 1 552 581 veteran patients receiving care in the US Veterans Health Administration system who were followed up through 2016, analyses of 1 693 449 screens for posttraumatic stress disorder administered in 2014 indicated a statistically significant 58% increase in the risk of suicide mortality at 1 day after a positive screening result. This risk of suicide mortality decreased over time. Meaning The study's findings indicate that additional mental health and suicide risk assessment may be warranted after a patient receives a positive result on the Primary Care–Posttraumatic Stress Disorder Screen.

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Section: Discussionmentioning

confidence: 99%

Association Between Positive Results on the Primary Care–Posttraumatic Stress Disorder Screen and Suicide Mortality Among US Veterans

et al. 2020

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“…In a survey conducted across 26 countries, fewer than half of respondents who meet criteria for PTSD reported seeking treatment for it (Koenen et al, ). A meta‐analysis spanning over 6,000 individuals estimated that 18%–39% of patients in secondary‐care mental health services have undetected PTSD and are likely being treated for diagnoses secondary to trauma (Zammit et al, ). In addition, rates of physical and sexual trauma among gastroenterology patients are high, with these trauma survivors displaying higher pain and functional disability (Drossman et al, ; Leserman et al, ).…”

Section: Comorbidity Of Psychiatric and Gi Tract Pathology And Their mentioning

confidence: 99%

Traumatic stress and the autonomic brain‐gut connection in development: Polyvagal Theory as an integrative framework for psychosocial and gastrointestinal pathology

Kołacz

Kovacic

Porges

2019

Developmental Psychobiology

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A range of psychiatric disorders such as anxiety, depression, and post‐traumatic stress disorder frequently co‐occur with functional gastrointestinal (GI) disorders. Risk of these pathologies is particularly high in those with a history of trauma, abuse, and chronic stress. These scientific findings and rising awareness within the healthcare profession give rise to a need for an integrative framework to understand the developmental mechanisms that give rise to these observations. In this paper, we introduce a plausible explanatory framework, based on the Polyvagal Theory (Porges, Psychophysiology, 32, 301–318, 1995; Porges, International Journal of Psychophysiology, 42, 123–146, 2001; Porges, Biological Psychology, 74, 116–143, 2007), which describes how evolution impacted the structure and function of the autonomic nervous system (ANS). The Polyvagal Theory provides organizing principles for understanding the development of adaptive diversity in homeostatic, threat‐response, and psychosocial functions that contribute to pathology. Using these principles, we outline possible mechanisms that promote and maintain socioemotional and GI dysfunction and review their implications for therapeutic targets.

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“…Thus, several effective treatments have been developed; however, mental healthcare for PTSD remains insufficient across countries (Kazlauskas et al, 2016;Koenen et al, 2017;Sareen, 2014). Treatment-seeking is low and delayed, and the supply of treatment itself is insufficient even in countries with a generally appropriate health system (Koenen et al, 2017;Zammit et al, 2018). Main barriers to seeking professional help after trauma include limited resources on the part of the health system, and on the part of the affected person, time constraints, a lack of knowledge about services, fear of negative social consequences, stigma, and shame (Kantor, Knefel, & Lueger-Schuster, 2017).…”

Section: Introductionmentioning

confidence: 99%

‘Help for trauma from the app stores?’ A systematic review and standardised rating of apps for Post-Traumatic Stress Disorder (PTSD)

Sander

Schorndanner

Terhorst

et al. 2020

European Journal of Psychotraumatology

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Background: Mobile health applications (apps) are considered to complement traditional psychological treatments for Post-Traumatic Stress Disorder (PTSD). However, the use for clinical practice and quality of available apps is unknown. Objective: To assess the general characteristics, therapeutic background, content, and quality of apps for PTSD and to examine their concordance with established PTSD treatment and self-help methods. Method: A web crawler systematically searched for apps targeting PTSD in the British Google Play and Apple iTunes stores. Two independent researchers rated the apps using the Mobile App Rating Scale (MARS). The content of high-quality apps was checked for concordance with psychological treatment and self-help methods extracted from current literature on PTSD treatment. Results: Out of 555 identified apps, 69 met the inclusion criteria. The overall app quality based on the MARS was medium (M = 3.36, SD = 0.65). Most apps (50.7%) were based on cognitive behavioural therapy and offered a wide range of content, including established psychological PTSD treatment methods such as processing of trauma-related emotions and beliefs, relaxation exercises, and psychoeducation. Notably, data protection and privacy standards were poor in most apps and only one app (1.4%) was scientifically evaluated in a randomized controlled trial. Conclusions: High-quality apps based on established psychological treatment techniques for PTSD are available in commercial app stores. However, users are confronted with great difficulties in identifying useful high-quality apps and most apps lack an evidence-base. Commercial distribution channels do not exploit the potential of apps to complement the psychological treatment of PTSD.

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Undetected post-traumatic stress disorder in secondary-care mental health services: systematic review

Cited by 42 publications

References 52 publications

Association Between Positive Results on the Primary Care–Posttraumatic Stress Disorder Screen and Suicide Mortality Among US Veterans

Association Between Positive Results on the Primary Care–Posttraumatic Stress Disorder Screen and Suicide Mortality Among US Veterans

Traumatic stress and the autonomic brain‐gut connection in development: Polyvagal Theory as an integrative framework for psychosocial and gastrointestinal pathology

‘Help for trauma from the app stores?’ A systematic review and standardised rating of apps for Post-Traumatic Stress Disorder (PTSD)

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