Reported trauma, post-traumatic stress disorder and major depression among primary care patients

BACKGROUND: Trauma is a necessary diagnostic criterion for post-traumatic stress disorder (PTSD). However, the nature of traumas experienced (e.g. assaultive versus non-assaultive) may influence whether any mental disorder will arise. Traumatic experiences may also be associated with other mental disorders, particularly major depressive disorder (MDD). This report examines the relationship of trauma history to the likelihood of full or partial PTSD and MDD. In addition, the study examines the frequency with which assaultive and non-assaultive traumas are reported by patients with full or partial PTSD and MDD. METHODS: Three hundred eighty-six primary care patients completed psychiatric symptom measures during their clinic visit. A subset of 132 participants completed a diagnostic interview within 2 weeks following the screening. RESULTS: Most patients reporting traumas did not meet criteria for a mental disorder. Patients reporting traumas were more likely to experience current MDD (27.8%) than current full or partial PTSD (20.0%) although a high percentage of patients with traumas (41.1%) had experienced full or partial PTSD diagnosis in their lifetime. Respondents reporting assaultive events as their most severe trauma, when compared with those whose most severe trauma was non-assaultive, were more likely to have met criteria for either full or partial PTSD in their lifetime, and were more likely to have current MDD. CONCLUSIONS: These findings suggest that trauma history is often not associated with psychopathology, and when it is, trauma is often associated with major depression rather than PTSD. The likelihood of psychopathology is increased for individuals reporting assaultive traumas.