Assault and Mental Disorders: A Cross-Sectional Study of Urban Adult Primary Care Patients

Abstract

Objective This study estimated the strength of associations between self-reported assault and psychiatric disorders among low-income, urban primary care patients who were predominantly female. Methods A sample of adult patients who consecutively presented at an urban primary care practice completed the Life Events Checklist (N=1,157). They were also screened for current major depression, panic disorder, generalized anxiety disorder, and substance use disorders with the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire; for bipolar disorder with the Mood Disorder Questionnaire; and for posttraumatic stress disorder (PTSD) with the PTSD Checklist–Civilian Version. A total of 977 of the respondents reported whether they had ever experienced an assault. Logistic regression was used to model associations between self-reported assault and screen status, controlling for relevant sociodemographic and clinical characteristics. Results Twenty-five percent of study participants endorsed a history of physical or sexual assault. Compared with patients without a history of assault, patients with a history of assault had significantly greater odds of screening positive for PTSD (odds ratio [OR]=1.97, 95% confidence interval [CI]=1.19–3.25), alcohol use disorder (OR=2.17, CI=1.07–4.41), and drug use disorder (OR=3.38, CI=1.14–9.98). Conclusion A history of assault was related to risk of screening positive for PTSD and a substance use disorder. These findings support assessment of trauma history among low-income primary care patients.

A Randomized, Controlled Pilot Study of a Single-Session Psychoeducation Treatment for Urban, Culturally Diverse, Trauma-Exposed Adults

“…Participants reported whether or not they had experienced the traumatic event (0=” happened to me ”, 1=” witnessed it ”, 2=” learned about it ”, 3=” not sure ”, 4=” does not apply ”). The traumatic events assessed were further categorized as assaultive traumas or non-assaultive traumas (per Glover, Olfson, Gameroff, & Neria, 2010). The following three questions on the LEC were used to create an “assault” variable: lifetime history of physical assault, assault with a weapon, sexual assault (Glover et al, 2010).…”

Inflammation and Traumatic Stress

“…Previously we have shown that PTSD is highly prevalent in health care-seeking urban women, with rates of 14.8% for current and 19.6% for lifetime PTSD, findings that have been supported in similar settings (Gillespie et al, 2009;Glover, Olfson, Gameroff, & Neria, 2010). Lower rates of PTSD in primary care-seeking men and women in nonurban settings with higher income are reported, with rates between 6% and 13% for current PTSD Gillespie et al, 2009;Spitzer et al, 2009).…”

Premières identifications d’un profil traumatique chez des patients hospitalisés en psychiatrie en Martinique

“…En effet, ce dernier touche de 12 % à 57,8 % des patients atteints de troubles bipolaires, de dépressions ou de schizophrénie (Gill et al, 2008, p. 693 ;Mueser et al, 1998, p. 493 ;Glover et al, 2010Glover et al, , p. 1018Thompson et al, 2010, p. 84).…”

“…De ce repérage systématique de la clinique post-traumatique découlera la prise en compte des comorbidités psychiatriques (Hegarty et al, 2004, p. 621 ;Afifi et al, 2012, p. 184 ;Zanarini et al, 2011, p. 349), notamment les conduites suicidaires (Godet-Mardirossian et al, 2011, p. 942 ;Stevens et al, 2013), des comorbidités addictologiques (Lawson et al, 2013, p. 127, ;Read et al, 2004Read et al, , p. 1665 et somatiques (Paras et al, 2009, p. 550 ;Spitzer et al, 2009Spitzer et al, , p. 1012Coughlin, S., 2011, p. 164), des conséquences sociales et économiques (Fang et al, 2012, p. 156)… Ainsi, en psychiatrie, Thompson et al (2010, p. 84) retrouvent dans une population de 92 patients (dont 56,5 % présentaient une dépression) 35,9 % d'expositions à des agressions sexuelles. Dans l'étude de Glover et al (2010de Glover et al ( , p. 1018) qui interrogeaient, avec la Life Events Checklist, les antécédents traumatiques de 977 patients (dont 70 % ont un trouble dépressif), les auteurs ont retrouvé 25 % de victimes d'agressions (dont 17 % physiques, 7 % sexuelles, 16 % avec armes ; Glover et al, 2010Glover et al, , p. 1018 (Brown et Lefaucheur, 2011, p. 73 ;Zanarini et al, 2011, p. 349 ;Ladois Do Pilar Rei, A., 2012, p. 83 ;Coid et al, 2001, p. 450 Ce chiffre représente le double du taux national français (7,7 ‰). Même si ces chiffres n'expliquent pas à eux seuls le nombre d'ÉSPT dans cette population, il est reconnu que le contexte socioéconomique d'une région puisse rendre compte des variations dans la réponse clinique au traumatisme (Spitzer et al, 2009, p. 80).…”