Does posttraumatic stress predict frequency of general practitioner visits in parents of terrorism survivors? A...

Background: Life threat to children may induce severe posttraumatic stress reactions (PTSR) in parents. Troubled mothers and fathers may turn to their general practitioner (GP) for help. Objective: This study investigated frequency of GP visits in mothers and fathers of adolescent and young adult terrorism survivors related to their own PTSR and PTSR in their surviving children. Method: Self-reported early PTSR (4-5 months post-disaster) in 196 mothers, 113 fathers and 240 survivors of the 2011 Utøya terrorist attack were linked to parents' three years pre- and post-disaster primary healthcare data from a national reimbursement claims database. Frequency of parents' GP visits was regressed on parent and child PTSR, first separately, then in combination, and finally by including an interaction. Negative binominal regressions, adjusted for parents' pre-disaster GP visits and socio-demography, were performed separately for mothers and fathers and for the early (<6 months) and delayed (6-36 months) aftermath of the terrorist attack. Results: Parents' early PTSR were significantly associated with higher early frequency of GP visits in mothers (rate ratio, RR = 1.31, 95%CI 1.09-1.56) and fathers (RR = 1.40, 95%CI 1.03-1.91). In the delayed aftermath, early PTSR were significantly associated with higher frequency of GP visits in mothers only (RR = 1.21, 95%CI 1.04-1.41). Early PTSR in children were not significantly associated with an overall increase in GP visits. On the contrary, in mothers, child PTSR predicted significant decrease in GP visits the delayed aftermath (RR = 0.83, 95%CI 0.71-0.97). Conclusions: Our study suggests that GPs may play an important role in identifying and providing for parents' post-disaster healthcare needs. GPs need to be aware that distressed individuals are likely to approach them following disasters and must prepare for both short- and long-term healthcare needs.