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Abstract

Objectives:

This study described utilization of specialty treatment for posttraumatic stress disorder (PTSD) at U.S. Department of Veterans Affairs (VA) facilities among veterans of Operation Enduring Freedom (OEF), in Afghanistan, or of Operation Iraqi Freedom (OIF), in Iraq, and non-OEF-OIF veterans recently diagnosed as having PTSD. It also identified predictors of receiving minimally adequate specialty treatment, defined as attending at least nine clinic visits within 365 days of screening positive for PTSD.

Methods:

VA administrative data were obtained for 869 veterans who screened positive for PTSD between November 7, 2006, and September 30, 2008, received a diagnosis of PTSD, and visited a PTSD specialty clinic operated by the VA in the Pacific Northwest at least once within a year of screening positive.

Results:

A total of 286 (33%) of the 852 veterans for whom complete data were available received minimally adequate specialty treatment; OEF-OIF veterans were less likely than non-OEF-OIF veterans to receive minimally adequate specialty treatment (29% versus 36%, p=.021) and attended fewer mean±SD visits to a PTSD clinic (8.2±11.4 versus 9.9±13.5, p=.045). Predictors of receiving minimally adequate specialty treatment included attending a PTSD clinic visit within 30 days of a positive screen, living in an urban location, and having psychiatric comorbidities.

Conclusions:

Most veterans with new PTSD diagnoses who initiated VA PTSD specialty care did not receive minimally adequate specialty treatment. Future studies should examine factors that lead to premature discontinuation of PTSD treatment and to what extent specialty treatment for PTSD is necessary. (Psychiatric Services 62:943–949, 2011)

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Figures and Tables

Figure 1 Retention in specialty treatment for PTSD among 405 OEF-OIF veterans and 464 non-OEF-OIF veterans
Table 1 Sociodemographic and clinical characteristics of 869 veterans who received specialty treatment for posttraumatic stress disorder (PTSD)
Table 2 Predictors of specialty treatment utilization for posttraumatic stress disorder (PTSD) among 395 veterans of Operation Enduring Freedom (Afghanistan) and Operation Iraqi Freedom (Iraq)
Table 3 Predictors of specialty treatment utilization for posttraumatic stress disorder (PTSD) among 457 veterans who did not serve in Operation Enduring Freedom (Afghanistan) or Operation Iraqi Freedom (Iraq)

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Cover: The South Gorge, Appeldore, Isles of Shoals, by Childe Hassam. Oil on canvas, 22¼ × 18 inches. Collection of the Newark Museum, Newark, New Jersey. Photo credit: the Newark Museum/Art Resource, New York.
Psychiatric Services
Pages: 943 - 949
PubMed: 21807835

History

Published online: 1 August 2011
Published in print: August 2011

Authors

Details

Mary W. Lu, M.D. [email protected]
Dr. Lu is affiliated with the Mental Health and Neurosciences Division and Mr. Duckart and Dr. Dobscha are with the Portland Center for the Study of Chronic, Comorbid Mental and Physical Disorders, Portland VA Medical Center, 3710 SW US Veterans Hospital Rd., Portland, OR 97239 (e-mail: [email protected]).
Dr. Lu and Dr. Dobscha are also with the Department of Psychiatry, and Dr. O'Malley is with the Biostatistics and Design Program, Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, Oregon.
Jonathan P. Duckart, M.P.S. [email protected]
Dr. Lu is affiliated with the Mental Health and Neurosciences Division and Mr. Duckart and Dr. Dobscha are with the Portland Center for the Study of Chronic, Comorbid Mental and Physical Disorders, Portland VA Medical Center, 3710 SW US Veterans Hospital Rd., Portland, OR 97239 (e-mail: [email protected]).
Jean P. O'Malley, M.P.H.
Dr. Lu and Dr. Dobscha are also with the Department of Psychiatry, and Dr. O'Malley is with the Biostatistics and Design Program, Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, Oregon.
Steven K. Dobscha, M.D. [email protected]
Dr. Lu is affiliated with the Mental Health and Neurosciences Division and Mr. Duckart and Dr. Dobscha are with the Portland Center for the Study of Chronic, Comorbid Mental and Physical Disorders, Portland VA Medical Center, 3710 SW US Veterans Hospital Rd., Portland, OR 97239 (e-mail: [email protected]).
Dr. Lu and Dr. Dobscha are also with the Department of Psychiatry, and Dr. O'Malley is with the Biostatistics and Design Program, Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, Oregon.

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