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[Trauma and posttraumatic stress symptoms in patients in German primary care settings]
P Kuwert1, S Hornung, H Freyberger
1Abteilung für Psychosomatische Medizin und Psychotherapie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Greifswald am Helios Hanseklinikum Stralsund, Rostocker Chaussee 70, 18437, Stralsund, Deutschland, kuwert@uni-greifswald.de.
Background:
Primary care settings have an important gatekeeping function to detect mental diseases, including trauma and posttraumatic stress disorders.
Objectives:
To assess the prevalence of trauma and posttraumatic symptoms in a first sample of northeast German primary care patients and to evaluate the diagnostic sensitivity and specificity of the general practitioners.
Material And Methods:
Traumatic experiences and posttraumatic stress disorders (PTSD) were assessed with self-rating questionnaires in a sample of N = 400 patients from 3 primary care facilities. Additionally, knowledge and diagnostic accuracy of the general practitioners were evaluated.
Results:
According to the results of the patient health questionnaire (PHQ-15) data from all patients, the majority of patients questioned showed slight to moderate stress from somatic symptoms. Of the patients with complete data 7 % (n = 25) had a complete PTSD according to the results of the questionnaire, which was also identified in the medical assessment with a sensitivity of 40 %. The stress resulting from posttraumatic symptoms was closely associated with the extent of somatic complaints.
Conclusion:
Patients with a history of trauma and posttraumatic symptoms are prevalent in primary care settings. An early diagnosis by the general practitioner can help patients to receive adequate treatment. Patients with somatoform disorders in particular should be screened for trauma and posttraumatic symptoms.
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