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Br J Gen Pract. May 1, 2006; 56(526): 349–354.
PMCID: PMC1837843
Posttraumatic stress disorder in primary care with special reference to personality disorder comorbidity
Manuel Gómez-Beneyto, MD, PhD, Professor of Psychiatry
Facultad de Medicina, University of Valencia, Valencia, Spain
José Salazar-Fraile, MD, PhD, Psychiatrist and Chief of Section and Vicent Martí-Sanjuan, Clinical Psychologist
Centro de Salud Mental de Paterna, Paterna, Spain
Luis Gonzalez-Luján, MD, PhD, Family Physician
Centro de Salud Mental de Paterna, Centro de Salud Serrería, Valencia, Spain
Address for correspondence Manuel Gómez-Beneyto, Professor of Psychiatry, Facultad de Medicina, Avenida Blasco Ibañez, 17, 46010 Valencia, Spain. E-mail: Manuel.Gomez-Beneyto/at/uv.es
Received January 23, 2005; Revised April 29, 2005; Accepted October 11, 2005.
Abstract
Background
Posttraumatic stress disorder (PTSD) is a common and disabling disturbance in primary care. Few studies have been carried out in primary care samples and none have taken into consideration the association between PTSD and personality disorder.
Aim
To describe prevalence and risk factors of PTSD and its comorbidity with personality disorder.
Setting
General practice centre in Valencia (Spain).
Method
Patients who had experienced at least one traumatic event in their lives were selected from a random sample attending a primary healthcare centre in Valencia and blindly assessed by trained professionals. Patients suffering from PTSD were compared with those who were not. PTSD and personality disorder diagnoses were established using CIDI and SCID-II interviews respectively. Sex, age at the time of experiencing trauma, frequency, multiplicity and type of trauma, dissociative symptoms, personality disorder and severity of PTSD were subjected to multivariate analysis to estimate the probability of developing PTSD and its duration.
Results
Life prevalence rate was 14% and current prevalence 9%. Dissociative symptoms and personality disorder were significantly associated with PTSD. Cluster analysis based on age, frequency and type of trauma revealed the existence of one subgroup composed mainly of women who had experienced frequent body-contact trauma at an early age, developed severe PTSD and suffer from a variety of personality disorders, particularly paranoid personality disorder. Time to the complete disappearance of symptoms was only explained by the initial severity of PTSD.
Conclusion
PTSD is a frequent disorder in general practice and it is often associated with personality disorder. Women who experienced high frequency body-contact traumatic events at an early age often suffer from personality disorder and present a particularly severe form of PTSD deserving referral to specialised care.
Keywords: epidemiology, personality disorder, posttraumatic stress disorder, stress
Articles from The British Journal of General Practice are provided here courtesy of
Royal College of General Practitioners