Unrecognized PTSD in Severe Mental Illness: Prevalence and Treatment Outcomes

Background: Post-traumatic stress disorder (PTSD) is a trauma and stress related psychiatric disorder that impacts millions of Americans each year. Although it has been found to be one of the costliest mental disorders with one of the highest rates of mental health service use, it is also one of the least recognized and treated disorders among psychiatric service providers with as few as 2 to 5 percent of trauma being recognized in individuals with severe mental illness. Unrecognized PTSD can impact social and emotional well-being, increased use of mental health services, loss of wages, and increasing demand of social welfare benefits which can ultimately take a toll on society (Rosenbaum, 2004; Resnick et al., 2003; Rosenbaum, 2004; Sharpless & Barber, 2012). Purpose: The present study built on previous research by examining three research questions: a) do gender differences exist in the rates of unrecognized PTSD; b) do racial differences exist in the rates of unrecognized PTSD; and, c) what role does unrecognized PTSD have on treatment outcomes? Methods: A retrospective chart review was conducted of 360 patients with severe mental illness who were hospitalized at an urban, state-funded psychiatric hospital between March 2016 and September 2016. Measures included the Posttraumatic Checklist (PCL-5), Global Assessment of Functioning (GAF), and change scores of the Affective Disorder Rating Scale (ADRS). Additionally, demographic information of the subjects was reviewed, as was their length of hospitalization and number of hospitalizations. Results: The present study did not indicate significant differences between gender and racial groups in regards to rates of unrecognized PTSD, nor were differences in treatment outcomes apparent. Conclusions: Despite the lack of significant findings, this study supported previous research indicating the rate of unrecognized PTSD. Further the findings indicate that the phenomenon of PTSD going unrecognized, cuts across demographic groups.Psychological, Health, and Learning Sciences, Department o