Clinical Practice Update 110

Scott Fields, PhD, William Johnson, MD    

Post Traumatic Stress Disorder (PTSD) is a potentially debilitating psychiatric illness that is quite common. The one year prevalence rate of PTSD in the United States (US) is 3.5% while the lifetime projected prevalence rate is 8.7%. PTSD prevalence is trending upward in many US communities due in part to issues related to the devastating effects of opioid use disorder, and the adverse childhood experiences that often accompany the cycle of addiction. While an array of treatments exist for PTSD, patients fail to get treatment at times due to the topic of the trauma not being fully addressed in the visit. Assessment of PTSD in the primary care clinic can be aided by brief clinical screeners of prior and present trauma. Providers have a dual task of managing the patient’s healthcare needs while being careful to avoid re-traumatizing the individual seeking help. Key concerns in addition to assessing for PTSD, include engaging in a collaborative dialogue with the patient about the physical examination, finding the right therapeutic intervention (e.g., pharmacologic, non-pharmacologic, combination), and managing patient visits to the clinic in a manner that is trauma informed. An inter-professional, collaborative approach to the diagnosis and treatment of PTSD in primary care clinics is encouraged, and will be further discussed.