Zielinski Melissa J, Alkov Danielle, McCauley Erin, Aminawung Jenerius A, Shavit Shira, Wang Emily A
Psychiatric Research Institute, University of Arkansas for Medical Sciences.
San Francisco Department of Public Health.
Psychol Trauma. 2024 May;16(4):692-700. doi: 10.1037/tra0001427. Epub 2023 Feb 2.
Posttraumatic stress disorder (PTSD) is prevalent among people who have been incarcerated. Here, we examined whether screening positive for PTSD was associated with other indicators of poor health, acute healthcare utilization, and poverty among primary care patients upon release from incarceration.
We conducted a cross-sectional survey in a national network of primary care clinics serving people recently released from incarceration. Participants were 416 patients who completed the Primary Care PTSD screen (PC-PTSD) and other questions about mental and physical health, acute healthcare utilization, and economic status within 6 months of release.
Screening positive for PTSD was associated with worse status across nearly all variables examined, including being more likely to report: poor/fair health (61.6% vs. 41.7%), current depressive symptoms (89.7% vs. 50.8%), lifetime depression diagnosis (63.3% vs. 35.3%), cannabis use since release (20.7% vs. 9.6%), homelessness (31.9% vs. 18.5%), having no cash on hand (56.3% vs. 39.0%) and severe food insecurity (29.3% vs. 18.2%; all s < .01). Reporting recent suicidality (14.3% vs. 7.0%), alcohol use since release (30.2% vs. 20.0%), and emergency department utilization (20.4% vs. 12.2%) was also more likely (all s ≤ .03). These trends were largely upheld when controlling for demographic characteristics and chronic physical health conditions using linear probability regression.
Primary care patients recently released from incarceration have a need for wrap-around services that address health challenges and poverty. Patients with significant PTSD symptoms face even greater challenges. Identification and treatment of PTSD both during and after incarceration is warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
创伤后应激障碍(PTSD)在曾经入狱的人群中很普遍。在此,我们研究了PTSD筛查呈阳性是否与从监狱释放后的初级保健患者的其他健康状况不佳指标、急性医疗服务利用情况和贫困状况相关。
我们在一个为刚从监狱释放的人群提供服务的全国性初级保健诊所网络中进行了一项横断面调查。参与者为416名患者,他们在释放后的6个月内完成了初级保健PTSD筛查(PC-PTSD)以及其他关于精神和身体健康、急性医疗服务利用情况和经济状况的问题。
PTSD筛查呈阳性与几乎所有所检查变量的较差状况相关,包括更有可能报告:健康状况差/一般(61.6%对41.7%)、当前有抑郁症状(89.7%对50.8%)、终生抑郁诊断(63.3%对35.3%)、释放后使用大麻(20.7%对9.6%)、无家可归(31.9%对18.5%)、手头没有现金(56.3%对39.0%)以及严重的粮食不安全(29.3%对18.2%;所有p<0.01)。报告近期有自杀倾向(14.3%对7.0%)、释放后饮酒(30.2%对20.0%)以及急诊部门就诊情况(20.4%对12.2%)的可能性也更高(所有p≤0.03)。当使用线性概率回归控制人口统计学特征和慢性身体健康状况时,这些趋势在很大程度上仍然成立。
刚从监狱释放的初级保健患者需要全面的服务来应对健康挑战和贫困问题。有显著PTSD症状的患者面临的挑战更大。在入狱期间和出狱后对PTSD进行识别和治疗是必要的。(PsycInfo数据库记录(c)2024美国心理学会,保留所有权利)