Comparing the Stability of Diagnosis in Full vs. Partial Posttraumatic Stress Disorder

VA Medical Center, White River Junction, VT 05009, USA.
The Journal of nervous and mental disease (Impact Factor: 1.69). 06/2012; 200(6):520-5. DOI: 10.1097/NMD.0b013e318257c6da
Source: PubMed


We studied differences in diagnostic stability between patients with full and patients with partial posttraumatic stress disorder (PTSD). We collected self-reported symptoms of PTSD, anxiety, depression, and functioning at a Veterans Affairs mental health clinic (n = 1962). We classified patients as meeting full or partial PTSD based upon their initial assessment. We performed Kaplan-Meier survival analysis to compare stability of diagnosis over time and Cox proportional hazards models to understand how comorbid symptoms and level of functioning confounded the relationship. We performed a chart review to examine differences in treatment received by the two groups. Patients in the partial PTSD group lost their diagnosis significantly faster and at significantly higher rates than did patients with full PTSD. Comorbid symptoms contributed significantly to this difference. Mental health treatments delivered to the two groups were similar. These diagnoses appear to be different, suggesting that people with partial PTSD may benefit from a different clinical approach.

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    • "Though subthreshold PTSD is consistently linked with significant impairment, its trajectory and stability over time is less clear. Some evidence suggests that subthreshold PTSD remits at a higher rate than full PTSD following trauma exposure (Blanchard et al., 1997) and that individuals with subthreshold PTSD are more likely to improve at a higher and faster rate than individuals with full PTSD (Shiner et al., 2012). It is difficult to make causal statements surrounding the course of subthreshold PTSD and the extent to which it may remit on its own, however, as neither of the above studies experimentally manipulated or examined potential effects of treatment on symptom remission. "

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