Vaughan Barney R, Lu Yun, Slama Natalie E, Does Monique B, Hirschtritt Matthew E, Ridout Kathryn K, Koshy Maria T, Young-Wolff Kelly C
Addiction Medicine Recovery Services, Kaiser Permanente, Walnut Creek, CA, USA.
Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA.
Perm J. 2025 Sep 15;29(3):15-23. doi: 10.7812/TPP/24.191. Epub 2025 May 22.
Posttraumatic stress disorder (PTSD) is often underdiagnosed based on medical records. This study aimed to estimate the prevalence and health care utilization of individuals with PTSD and other trauma-related disorders in a large, integrated health care system.
Adults (between the ages of 18 and 65) with Kaiser Permanente Northern California membership and ≥ 1 outpatient visit in 2022 were eligible. Unspecified/other specified trauma and stressor-related disorder, acute stress disorder, and PTSD were based on diagnosis codes from the International Classification of Diseases, 10th Revision, Clinical Modification. The Primary Care PTSD (PC-PTSD) Scale was used as a screening tool. Prevalence was assessed overall and among the subset of patients seen in primary care, psychiatry, and addiction medicine. To contextualize health care utilization, the authors compared patients with trauma-related disorders to those with major depressive disorder.
Of the 2,128,670 eligible adults, the overall prevalence of trauma-related diagnoses and positive screening on PC-PTSD was 4.9% (103,947); 1.3% (n = 27,670) had PTSD, 1.9% (n = 41,205) had unspecified/other specified trauma and stressor-related disorder, 0.1% (n = 1818) had acute stress disorder, and 1.6% (n = 33,254) screened positive on PC-PTSD without a trauma-related International Classification of Diseases code. Prevalence of trauma-related diagnoses by department was 18.3% (n = 47,516) in psychiatry, 16.5% (n = 3816) in addiction medicine, and 3.4% (n = 67,469) in primary care. There were no clinically meaningful differences in health care utilization between those with trauma-related diagnoses compared with major depressive disorder.
Broadly defining trauma-related disorders and substantial symptoms may provide a more accurate representation of the actual prevalence of PTSD in a health care system. These data may help health care leaders plan treatment options for this diverse group of individuals.
创伤后应激障碍（PTSD）在医疗记录中常常被漏诊。本研究旨在评估一个大型综合医疗系统中患有创伤后应激障碍及其他创伤相关疾病的个体的患病率和医疗服务利用情况。
符合条件的为2022年拥有北加利福尼亚凯撒医疗集团会员资格且门诊就诊次数≥1次的18至65岁成年人。未特定/其他特定的创伤及应激源相关障碍、急性应激障碍和创伤后应激障碍是根据《国际疾病分类》第10次修订版临床修订本的诊断编码确定的。初级保健创伤后应激障碍（PC-PTSD）量表用作筛查工具。总体及在初级保健、精神病学和成瘾医学科室就诊的患者亚组中评估患病率。为了解医疗服务利用情况，作者将患有创伤相关疾病的患者与患有重度抑郁症的患者进行了比较。
在2128670名符合条件的成年人中，创伤相关诊断及PC-PTSD筛查阳性的总体患病率为4.9%（103947人）；1.3%（n = 27670）患有创伤后应激障碍，1.9%（n = 41205）患有未特定/其他特定的创伤及应激源相关障碍，0.1%（n = 1818）患有急性应激障碍，1.6%（n = 33254）在PC-PTSD筛查中呈阳性但无创伤相关的国际疾病分类编码。各科室创伤相关诊断的患病率在精神病学科室为18.3%（n = 47516），在成瘾医学科室为16.5%（n = 3816），在初级保健科室为3.4%（n = 67469）。与重度抑郁症患者相比，患有创伤相关疾病的患者在医疗服务利用方面没有临床意义上的差异。
广泛定义创伤相关障碍和显著症状可能更准确地反映医疗系统中创伤后应激障碍的实际患病率。这些数据可能有助于医疗领导者为这群不同的个体规划治疗方案。
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