Lifetime Trauma Exposure and Mental Health Status Among Veteran Administration Primary Care Patients

John R. Freedy, MD, PhD
Trident Family Medicine Residency Program
Charleston, South Carolina

Kathryn M. Magruder, PhD
Department of Psychiatry & Behavioral Sciences
Medical University of South Carolina
Charleston, South Carolina

Introduction
Traumatic life events and associated mental health problems are a major public health issue. The current study attempts to document lifetime prevalence of traumatic events and mental health problems (PTSD) among a large cohort of primary care patients.
Methods
Four Veteran’s Administration primary care clinics in the southeastern United States provided participants. A semi-random subset of patients, including a female over-sample, was selected. Participation rate was 74%.
Project data were collected via: written questionnaires, structured interviews, and record review. Variables of interest included: demographic characteristics, lifetime traumatic event prevalence, & lifetime PTSD. Structured interviews were used to assess lifetime trauma and mental health diagnosis.
Results
Participants included 676 men and 183 women. Most participants reported one or more lifetime traumatic event (91.63%). Significant gender differences emerged with men more likely to report combat experience while women were more likely to report various types of physical and sexual assaults.
Lifetime PTSD was common. There were no significant gender differences in PTSD (11.76%).
Gender differences emerged when contrasting trauma history with mental health condition. For example, men with combat experience were more likely to report PTSD (92.59% v. 51.62%, p<.001), but women who experienced physical assault with a weapon were more likely to report PTSD (75.0% v 19.66%, p<.007).
Conclusions
1. Lifetime traumatic events were common.
2. Lifetime PTSD was common.
3. Gender differences existed in both lifetime traumatic events and mental health problems.
4. The relationship between trauma and mental health (PTSD) differs by gender.