Background: Post-Traumatic Stress Disorder (PTSD) is a syndrome that can emerge after exposure to a traumatic event. In the veteran population, the strongest predictor of developing PTSD is frequency and intensity of direct combat exposure. The 2010 Veterans Affairs (VA)/Department of Defense (DoD) guidelines for the treatment of PTSD published in 2010 recommend psychotherapy techniques and/or pharmacotherapy (selective serotonin reuptake inhibitor or venlafaxine) as initial management.Objective: This study aimed to determine whether Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans received treatment for PTSD in concordance with VA/DoD guidelines.Methods: A retrospective chart review was conducted for 400 patients at the South Texas Veterans Health Care System (STVHCS) with OEF/OIF service who had a PTSD-related encounter between September 1, 2011 and August 31, 2012. The primary outcome was the percentage of OEF/OIF veterans with PTSD who received treatment in concordance with VA/DoD guidelines. Secondary outcomes included length of time veterans waited to see mental health (MH) providers, and comparison of outcomes between patients who received evidence-based treatment to those that did not.Results: Two-hundred and seventy-nine patients met the inclusion criteria and the majority of patients (n = 183, 65.5%) received treatment consistent with the VA/DoD Guidelines. The overall median wait time to see a MH provider was 10 +/−26.64 days, and did not differ significantly between groups. Patients whose treatment did not follow guideline recommendations had statistically more psychiatric emergency department (ED) visits (10 vs. 17, p=0.0026).Conclusions: The majority of patients at the STVHCS received treatment for PTSD in concordance with the VA/DoD guidelines, and 67.7% of patients saw MH providers within 14 days. Patients who did not receive guideline-supported treatment had more frequent ED visits, but the reason for this is unknown and may be due to a number of factors not accounted for in this review. The number of ED visits may be reduced by fully utilizing the processes in place that work to improve veteran access to MH care and the provision of guideline-based treatment. Prospective studies are needed to clearly elucidate the factors that may impact whether or not patients receive recommended treatment.
Sexual Dysfunction in Male Operation Enduring Freedom/Operation Iraqi Freedom Patients With Severe Post-Traumatic Stress Disorder
