Treatment of Veterans With PTSD at a VA Medical Center: Primary Care Versus Mental Health Specialty Care
Abstract
Objective
Methods
Results
Conclusions
Methods
Sample and sources of data
Measures
Analyses
Results
Primary care(N=524) | Mental healthspecialty care(N=3,620) | ||||||
---|---|---|---|---|---|---|---|
Characteristic | N | % | N | % | χ2 | p | df |
Gender | 5 | .02 | 1 | ||||
Male | 449 | 95 | 3,350 | 93 | |||
Female | 25 | 5 | 270 | 7 | |||
Age (years) | 27.9 | <.001 | 4 | ||||
<40 | 120 | 23 | 849 | 23 | |||
40–49 | 35 | 7 | 370 | 10 | |||
50–64 | 267 | 51 | 1,923 | 53 | |||
65–74 | 52 | 10 | 309 | 9 | |||
≥75 | 50 | 9 | 169 | 5 | |||
Income | 1.34 | ns | 2 | ||||
<$15,000 | 239 | 46 | 1,719 | 48 | |||
$15,000–$25,000 | 59 | 11 | 435 | 12 | |||
>$25,000 | 226 | 43 | 1,466 | 40 | |||
Pension | 6 | 1 | 81 | 2 | 2.66 | ns | 1 |
Theater of war | 32.00 | <.001 | 4 | ||||
OEF/OIF | 126 | 24 | 801 | 22 | |||
WWII | 34 | 6 | 89 | 2 | |||
Vietnam | 288 | 55 | 1,976 | 55 | |||
Post-Vietnam | 27 | 5 | 298 | 8 | |||
Gulf War era | 146 | 28 | 1,093 | 30 | |||
Place of residence | 4.24 | .04 | 1 | ||||
Urban | 464 | 91 | 3,289 | 94 | |||
Rural | 44 | 9 | 219 | 6 | |||
Diagnoses | |||||||
Dementia/Alzheimer’s | 11 | 2 | 25 | 1 | 10.5 | .001 | 1 |
Schizophrenia | 4 | 1 | 191 | 5 | 20.8 | <.001 | 1 |
Bipolar disorder | 3 | 6 | 324 | 9 | 44.2 | <.001 | 1 |
Alcohol abuse or dependence | 42 | 8 | 787 | 22 | 53.9 | <.001 | 1 |
Drug abuse or dependence | 20 | 3 | 589 | 16 | 56.6 | <.001 | 1 |
Major depressive disorder | 22 | 4 | 993 | 27 | 134 | <.001 | 1 |
Dysthymia and other depression | 73 | 14 | 1,291 | 33 | 79.6 | <.001 | 1 |
Anxiety disorder | 5 | 1 | 57 | 1 | 1.2 | ns | 1 |
Other psychiatric disorder | 34 | 6 | 589 | 16 | 34.3 | <.001 | 1 |
Total (N=4,144) | Primary care (N=524) | Mental health specialty care (N=3,620) | ||||||
---|---|---|---|---|---|---|---|---|
Class of medication | N | % | N | % | N | % | χ2a | p |
Any psychotropic medication | 3,098 | 75 | 190 | 36 | 2,908 | 80 | 471 | <.001 |
Antidepressant | 2,650 | 64 | 136 | 26 | 2,514 | 69 | 305 | <.001 |
Antipsychotic | 1,001 | 24 | 8 | 1 | 993 | 27 | 168 | <.001 |
Anxiolytic/sedative/hypnotic | 1,719 | 41 | 78 | 15 | 1,641 | 45 | 175 | <.001 |
Stimulant | 68 | 2 | 0 | — | 68 | 2 | 10 | .002 |
Mood stabilizer | 777 | 19 | 39 | 7 | 738 | 20 | 50.3 | <.001 |
Lithium | 82 | 2 | 0 | — | 82 | 2 | 12.1 | .001 |
Total(N=4,144) | Primary care(N=524) | Mental health specialty care (N=3,620) | |||||
---|---|---|---|---|---|---|---|
Class of medication | M | M | SD | M | SD | Fa | Pr>F |
Any psychotropic medication | 14.8 | 3.20 | 8.22 | 16.48 | 23.17 | 169.04 | <.001 |
Antidepressant | 6.77 | 1.67 | 5.26 | 7.50 | 10.80 | 147.88 | <.001 |
Antipsychotic | 2.81 | .10 | .96 | 3.21 | 9.39 | 57.51 | <.001 |
Anxiolytic/sedative/hypnotic | 3.43 | .94 | 2.97 | 3.79 | 5.49 | 98.29 | <.001 |
Stimulant | .13 | 0 | — | .14 | 1.41 | 5.66 | .017 |
Mood stabilizer | 1.39 | .48 | 2.62 | 1.52 | 5.07 | 21.29 | <.001 |
Lithium | .24 | 0 | — | .28 | 2.67 | 5.95 | .015 |
Discussion
Conclusions
Acknowledgments and disclosures
References
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