Samson A Y, Bensen S, Beck A, Price D, Nimmer C
Research and Development Department, Rocky Mountain Division, Kaiser Permanente, Denver, Colorado, USA.
J Fam Pract. 1999 Mar;48(3):222-7.
Primary care providers are aware of the importance of identifying depression and anxiety in their patients. The diagnosis of posttraumatic stress disorder (PTSD), however, is less of a priority.
Primary care physicians and nurse practitioners in an outpatient facility of a large health maintenance organization administered a psychiatric screening questionnaire to patients whom they suspected had depression or anxiety. Patients with positive results were referred for immediate consultation with a clinical psychologist.
One hundred fourteen (38.6%) of the 296 patients referred for consultation met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnostic criteria for PTSD. The most frequent traumas associated with PTSD were adult domestic violence and childhood abuse. Patients with a diagnosis of PTSD were frequent users of medical services in the 12 months before diagnosis. The majority of patients sought treatment in primary care settings, not mental health settings.
Patients with PTSD often visit outpatient primary care settings. Medical providers may identify symptoms of depression or anxiety but may not recognize PTSD because of the high degree of overlap between these conditions, and the lack of familiarity with PTSD diagnostic criteria. We provide screening questions that may help physicians detect PTSD in their practices.
初级保健提供者意识到识别患者抑郁和焦虑症状的重要性。然而，创伤后应激障碍（PTSD）的诊断却并非首要任务。
一家大型健康维护组织门诊机构的初级保健医生和执业护士，对他们怀疑患有抑郁或焦虑的患者进行了一项精神科筛查问卷测试。结果呈阳性的患者被转介立即咨询临床心理学家。
在被转介咨询的296名患者中，有114名（38.6%）符合《精神障碍诊断与统计手册》（第四版）中PTSD的诊断标准。与PTSD相关的最常见创伤是成人家庭暴力和童年期虐待。被诊断为PTSD的患者在诊断前12个月内频繁使用医疗服务。大多数患者在初级保健机构而非心理健康机构寻求治疗。
PTSD患者经常前往门诊初级保健机构就诊。医疗服务提供者可能会识别出抑郁或焦虑症状，但由于这些病症之间存在高度重叠，且对PTSD诊断标准缺乏了解，可能无法识别出PTSD。我们提供了一些筛查问题，可能有助于医生在其诊疗工作中检测出PTSD。
