Knut W Soergaard

Purpose The prevalence of PTSD differs by gender. Pre-existing psychiatric disorders and different traumas experienced by men and women may explain this. The aims of this study were to assess (1) incidence and prevalence of exposure to traumatic events and PTSD, (2) the effect of pre-existing psychiatric disorders prior to trauma on the risk for PTSD, and (3) the effect the characteristics of trauma have on the risk for PTSD. All stratified by gender. Method CIDI was used to obtain diagnoses at the interview stage and retrospectively for the general population N = 1634. Results The incidence for trauma was 466 and 641 per 100,000 PYs for women and men, respectively. The incidence of PTSD was 88 and 31 per 100,000 PYs. Twelve month and lifetime prevalence of PTSD was 1.7 and 4.3 %, respectively, for women, and 1.0 and 1.4 %, respectively, for men. Pre-existing psychiatric disorders were risk factors for PTSD, but only in women. Premeditated traumas were more harmful. Conclusion Gender differences were observed regarding traumatic exposure and in the nature of traumas experienced and incidences of PTSD. Men experienced more traumas and less PTSD. Pre-existing psychiatric disorders were found to be risk factors for subsequent PTSD in women. However, while trauma happens to most, it only rarely leads to PTSD, and the most harmful traumas were premeditated ones. Primary prevention of PTSD is thus feasible, although secondary preventive efforts should be gender-specific.

In a rural area in Northern Norway Camberwell Assessment of Needs (CAN), a contact checklist, GAF and BPRS were used to determine the number of met and unmet needs, and extent of contact with 10 different social-and health services in a group of long term psychiatric patients. The group consisted of 33 persons with schizophrenia and 24 persons with anxiety or depressive disorders, both set according to ICD-10. None of the patients were institutionalised at the time of the interview. Only patient-identified needs were used in the analysis. As expected, persons with schizophrenia had a higher number of total needs (7.1 and 4.7) and of unmet basic needs (CAN 1-5) and health needs (CAN 6, 7, 9, 10) than persons with anxiety or depression. No difference was found for social needs. In both groups total number of needs (met and unmet) and number of unmet needs was generally found in the areas of activities, psychological distress, psychotic symptoms and social relations. Total number of needs and number of unmet needs correlated positively with symptom-level. A high number of needs (met and unmet) was related to use of primary care or municipality services, whereas a high symptom level was related to use of mental health services. Multiple regression analyses showed that in a model explaining 40% of the variance, use of services was predicted by low GAF, a high number of patient identified health needs and younger age.

Patient satisfaction is an important, but controversial part of health service evaluation. This study dealt with how acknowledgement of illness and treatment needs effected the distribution of positive, neutral and negative evaluations in a group of first time admitted patients to a psychiatric hospital.