Well-being, physical functioning, and use of health services in the elderly with PTSD and subthreshold PTSD

To measure the impact of PTSD and subthreshold PTSD on daily life functioning, well-being and health care use in a community based-sample of the elderly population in the Netherlands.

Consequences of PTSD were investigated in an elderly community-based population (LASA study) by comparing three groups: subjects with PTSD, with subthreshold PTSD, and a reference group. Indicators of well-being (loneliness, self-perceived health and satisfaction with life), disability (days spent in bed and disability days) and use of health care (general practitioners, medical specialists, psychiatrists, mental health care, social workers and professional home care) were investigated.

In comparison to the reference group, subjects with PTSD or subthreshold PTSD spent more days in bed due to illness and had more disability days, even when corrected for concurring other diseases or functional limitations. They were less satisfied with life in general, used health care for predominantly somatic care and evaluated the care they received to be inadequate. Psychotropic drugs, if prescribed, were predominantly benzodiazepines and seldom antidepressants.

The findings strongly suggest that elderly with either PTSD or subthreshold PTSD suffer grave impairments in daily life, are less satisfied with life and do not receive optimum treatment. Especially elderly with PTSD frequently visit medical specialists but are rarely treated by psychiatrists or other mental health professionals, nor do they receive antidepressant treatment from their GP. Lack of adequate treatment may be the cause of dissatisfaction with the care they receive.