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Dr. Bob is Robert Hsiung, MD,
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Posted by Phillipa on August 23, 2011, at 21:19:23
I almost find this humorous as one statement in Particular is made that "Depression is Easy To Treat" and a regular doc can do this. Phillipa
From Medscape Medical News > Psychiatry
New Tool a More Accurate Predictor of PTSD
Test Quick and Easy to Administer
Fran LowryAuthors and Disclosures
August 22, 2011 A new test that screens for posttraumatic stress disorder (PTSD) takes about 5 minutes to administer, appears to outperform other screening methods, and can be easily incorporated into clinical practice, according to new research published online July 20 in General Hospital Psychiatry.
The New York PTSD Risk Score was developed by Joseph Boscarino, PhD, MPH, of the Center for Health Research, Geisinger Clinic, Danville, Pennsylvania, and colleagues.
The simple, 10-item prediction tool includes core PTSD symptoms plus depression symptoms, access to care status, sleep disturbance, and trauma history. It is highly successful in predicting PTSD after traumatic exposures in different clinical populations, including war veterans, injured people, and those experiencing domestic violence, Dr. Boscarino told Medscape Medical News.
Dr. Joseph Boscarino"Our objective was to develop a brief screening tool that is quick and easy to use in a primary care setting so clinicians can determine who has the condition and then take the next step, whether it is additional testing or referral for treatment," he said.
Dr. Boscarino and his team used data collected in New York City after the 9/11 World Trade Center disaster and other trauma data to develop the new tool.
A number of screens are available, including the Primary Care PTSD Screen, which is used among Department of Defense and Department of Veterans Affairs personnel and also in civilians.
"We looked at everything that was out there in the PTSD area and then went back and looked at additional factors that should be included in the screening," said Dr. Boscarino.
"The analogy would be the Framingham Risk Score that is used to estimate a person's risk for future coronary heart disease. Every so many years, this is revised, and other risk factors are included as more data become available. This is what we did," he added.
Testing in Veterans
The researchers found that the early screeners worked relatively well. However, when they added 4 new elements depression, sleep disturbance, access to care status, and trauma exposure the result was a more sensitive and specific screening test.
The researchers also found that men and women require different screening tests to accurately predict PTSD.
"This is what you find in most medical screeners. For instance BMI [body mass index] tables are different for men and women," Dr. Boscarino said. "It makes sense. The risk factors and variables for PTSD onset are different for men and women. Women get to trauma often times from domestic situations, and they are more sensitive. They have different sleep problems, different levels of depression. Some of this is hormonally based. We are exploring these differences currently."
Being able to predict a person's risk for PTSD early should result in more effective treatment, Dr. Boscarino said.
"We found this during 9/11. Focused brief interventions can be highly effective if they are given in close proximity to the exposure, but if given years later, they may not be so effective, it may be very difficult to have a big impact," he said. "Doing this test, which takes only about 5 minutes, in a primary care clinic, can help direct patients to needed care more expeditiously."
He added that the New York PTSD Risk Score may prove to be useful to the military and help predict people most at risk in the event that they are deployed in combat.
"We are planning to use this test on Iraq and Afghan veterans who have recently returned to see how well it works. We have been contacted by the defense department. They are using their current instruments now, but they are interested in starting to use this new screen," he said.
Better Detection, Earlier Treatment
Medscape Medical News invited Spencer Eth, MD, psychiatrist at the Miami VA Medical Center, to comment on this article.
Dr. Eth confessed that the statistical methods used to develop the new screen were "far beyond my capability" and that most clinical psychiatrists would not be able to understand them.
"Nor do they need to, because if this went to a peer review process undoubtedly that included a statistician or methodologist, and I am assuming that the data were clean, the statistical analysis was appropriate, and the findings are as solid as they say," he said.
That being the case, Dr. Eth said that such a streamlined screening tool for PTSD may not have the same utility as the Patient Health Questionnaire 9, which is currently used in a primary care setting to screen for depression.
"Depression is relatively easy to treat, and the primary care doc can prescribe antidepressants. I'm not sure that a PTSD screening instrument would turn out to be as useful because there is no easy treatment at hand as there is for depression," Dr. Eth said.
Unlike depression, which often responds to medication only, most PTSD treatments require psychotherapy in addition to medication.
"This new screening tool could lead to better detection of PTSD but that would generally mean a referral rather than initiated treatment," he said. "But it's always good to identify patients who have psychiatric illness and refer them for care, in the same way that primary care physicians diagnose other medical illnesses that require specialist care."
The study was supported by the National Institute of Mental Health, the Pennsylvania Department of Health, and the Geisinger Clinic Endowment. Dr. Boscarino and Dr. Eth have disclosed no relevant financial relationships.
Gen Hosp Psychiatry. Published online July 20, 2011
Posted by floatingbridge on August 24, 2011, at 1:45:19
In reply to New Screen For PTSD Diferent In Females males, posted by Phillipa on August 23, 2011, at 21:19:23
That is pretty ironic on this board, depression being easy to treat.
I wonder how the exposure to trauma is assessed. There can be a tendency to deny trauma in some PTSD cases.
Well, at least it is hitting the mainstream.
Also humorous is that women may have hormonal vulnerabilities. Like only women have hormones. But I don't
think that was the intended meaning. I think it's true to an extent regarding estrogen. I've been thinking lately that many conditions, PTSD for example, may have strong endocrine components.
Posted by Phillipa on August 24, 2011, at 19:50:09
In reply to Re: New Screen For PTSD Diferent In Females males » Phillipa, posted by floatingbridge on August 24, 2011, at 1:45:19
FB that's an interesting thought. Yes out there the PTSD but wait til you see what came through as a newsbreak on SSRI's celexa in Particular was named. Love Phillipa
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