Posttraumatic stress disorder patients in gynecological practice

Purpose: The aim of the study was to investigate the prevalence of traumatic events and of post traumatic stress disorder (PTSD) in primary care gynecological practice. Material and Methods: Study participants were women who presented to a primary care gynecologic practice in Germany between September and December 2002. The main instruments used for measurement were SCL-90-R and Posttraumatic Diagnostic Scale (PDS-d-1). Patients with trauma who fulfilled DSM IV criteria and who agreed to further participation received the Brief Symptom Inventory BSI of Derogatis, the Impact-of-Event-Scale (IES-R) and the questionnaire of dissociative symtoms (FDS). Results: Out of 500 questionnaires 498 (99.6%) were completed. The women reported the following traumatic events: severe accident (19.9%), nature disaster (3.2%), violent attack by a family member (6.2%) or by a foreign person (5.8%), sexual attack by a family member (2.8%) or a foreign person (3.6%), sexual contact when aged younger than 18 years with a person 5 years and more older (12.2%); 14.5% reported a severe disease, 12% pregnancy, 12.4% birth, 11% post partum period and 6.6% a gynecologic illness or operation and 11% a professional traumatic event as a severe traumatic event. Overall, 46 (9.3%) women met the criteria of PTSD. Gynecologic symptoms significantly associated with PTSD were mastodynia (p = 0.000), symptoms of premenstrual tension (p = 0.001), urinary incontinence (p = 0.007) and dysmenorrhea (p = 0.024). Conclusion: Trauma was common in this population. Attention by primary care gynecologists to a history of trauma could improve the detection of this disabling disorder.