Generic placeholder image

Current Psychopharmacology

Editor-in-Chief

ISSN (Print): 2211-5560
ISSN (Online): 2211-5579

Research Article

Psychotropic Medication Use among Traumatized Individuals with and without Psychiatric Histories

Author(s): Alan R. King*, Sara K. Kuhn, Stephanie Brezinski, Michael Jowkar and Kourtney Smith

Volume 8, Issue 3, 2019

Page: [194 - 206] Pages: 13

DOI: 10.2174/2211556008666191003103449

Abstract

Background: Prescription rates for major classes of psychotropic medication were examined among respondents with and without histories of trauma and PTSD. While traumatized patients access primary health care at higher rates than normative counterparts, the extent to which they rely on psychiatric medications has not been well established.

Methods: This study surveyed college (N=2,320) and national (N=663) respondents. Trauma history was defined using the primary DSM-5 diagnostic criterion for Post- Traumatic Stress Disorder. Four hypotheses were tested: 1) medication reliance was expected to occur more frequently among respondents reporting a trauma history and PTSD than normative counterparts; 2) medication reliance was expected to occur more frequently among respondents reporting a trauma history without PTSD than normative (no trauma) counterparts; 3) gender differences in these associations between trauma exposure and medication history were not expected; 4) associations between trauma exposure and medication history were expected to be similar for college and national respondents.

Results: Support was found for these four hypotheses. Significant associations between self-reported trauma and reliance on psychotropic medications remained even after control of variance associated with gender, sample composition, and PTSD diagnosis. Recollections of a traumatic event as defined by the DSM-V criteria for PTSD increased the odds of being prescribed five different classes of psychiatric medication.

Conclusion: Trauma exposure both with and without co-occurring mental health conditions was associated with higher reliance on psychotrophic medications. The clinical implications of these patterns remain unclearly delineated. The cross-sectional correlation analyses relied upon in this study precluded meaningful onferences regarding the causality and/or directionality of these relationships.

Keywords: Antidepressants, antipsychotics, anxiolytics, mood-stabilizing medications, post-traumatic stress disorder, prescription patterns, psychotropic medication, trauma.

Graphical Abstract
[1]
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington, D.C.: American Psychiatric Publishing 2013.
[2]
Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) study. Am J Prev Med 1998; 14(4): 245-58.
[http://dx.doi.org/10.1016/S0749-3797(98)00017-8] [PMID: 9635069]
[3]
Dong M, Dube SR, Felitti VJ, Giles WH, Anda RF. Adverse childhood experiences and self-reported liver disease: new insights into the causal pathway. Arch Intern Med 2003; 163(16): 1949-56.
[http://dx.doi.org/10.1001/archinte.163.16.1949] [PMID: 12963569]
[4]
Dong M, Giles WH, Felitti VJ, et al. Insights into causal pathways for ischemic heart disease: adverse childhood experiences study. Circulation 2004; 110(13): 1761-6.
[http://dx.doi.org/10.1161/01.CIR.0000143074.54995.7F] [PMID: 15381652]
[5]
Dube SR, Anda RF, Felitti VJ, Edwards VJ, Croft JB. Adverse childhood experiences and personal alcohol abuse as an adult. Addict Behav 2002; 27(5): 713-25.
[http://dx.doi.org/10.1016/S0306-4603(01)00204-0] [PMID: 12201379]
[6]
Dube SR, Felitti VJ, Dong M, Chapman DP, Giles WH, Anda RF. Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. Pediatrics 2003; 111(3): 564-72.
[http://dx.doi.org/10.1542/peds.111.3.564] [PMID: 12612237]
[7]
Chapman DP, Whitfield CL, Felitti VJ, Dube SR, Edwards VJ, Anda RF. Adverse childhood experiences and the risk of depressive disorders in adulthood. J Affect Disord 2004; 82(2): 217-25.
[http://dx.doi.org/10.1016/j.jad.2003.12.013] [PMID: 15488250]
[8]
Hillis SD, Anda RF, Felitti VJ, Nordenberg D, Marchbanks PA. Adverse childhood experiences and sexually transmitted diseases in men and women: a retrospective study. Pediatrics 2000; 106(1) E11
[http://dx.doi.org/10.1542/peds.106.1.e11] [PMID: 10878180]
[9]
Ogle CM, Block SD, Harris LS, et al. Autobiographical memory specificity in child sexual abuse victims Dev Psychopathol 2013; 25(2): 321-32.
[http://dx.doi.org/10.1017/S0954579412001083] [PMID: 23627947]
[10]
Whitfield CL, Dube SR, Felitti VJ, Anda RF. Adverse childhood experiences and hallucinations. Child Abuse Negl 2005; 29(7): 797-810.
[http://dx.doi.org/10.1016/j.chiabu.2005.01.004] [PMID: 16051353]
[11]
Sledjeski EM, Speisman B, Dierker LC. Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey-replication (NCS-R). J Behav Med 2008; 31(4): 341-9.
[http://dx.doi.org/10.1007/s10865-008-9158-3] [PMID: 18553129]
[12]
Mark TL, Levit KR, Buck JA. Datapoints: psychotropic drug prescriptions by medical specialty. Psychiatr Serv 2009; 60(9): 1167.
[http://dx.doi.org/10.1176/ps.2009.60.9.1167] [PMID: 19723729]
[13]
Mojtabai R, Olfson M. National patterns in antidepressant treatment by psychiatrists and general medical providers: results from the national comorbidity survey replication. J Clin Psychiatry 2008; 69(7): 1064-74.
[http://dx.doi.org/10.4088/JCP.v69n0704] [PMID: 18399725]
[14]
Pagura J, Katz LY, Mojtabai R, Druss BG, Cox B, Sareen J. Antidepressant use in the absence of common mental disorders in the general population. J Clin Psychiatry 2011; 72(4): 494-501.
[http://dx.doi.org/10.4088/JCP.09m05776blu] [PMID: 21294990]
[15]
Mojtabai R, Olfson M. Proportion of antidepressants prescribed without a psychiatric diagnosis is growing. Health Aff 2011; 30(8): 1434-42.
[http://dx.doi.org/10.1377/hlthaff.2010.1024] [PMID: 21821561]
[16]
Simon GE, Stewart C, Beck A, et al. National prevalence of receipt of antidepressant prescriptions by persons without a psychiatric diagnosis. Psychiatr Serv 2014; 65(7): 944-6.
[http://dx.doi.org/10.1176/appi.ps.201300371] [PMID: 24788368]
[17]
Phifer J, Skelton K, Weiss T, et al. Pain symptomatology and pain medication use in civilian PTSD. Pain 2011; 152(10): 2233-40.
[http://dx.doi.org/10.1016/j.pain.2011.04.019] [PMID: 21665366]
[18]
Schwartz AC, Bradley R, Penza KM, et al. Pain medication use among patients with posttraumatic stress disorder. Psychosomatics 2006; 47(2): 136-42.
[http://dx.doi.org/10.1176/appi.psy.47.2.136] [PMID: 16508025]
[19]
Boscarino JA, Galea S, Ahern J, Resnick H, Vlahov D. Psychiatric medication use among Manhattan residents following the World Trade Center disaster. J Trauma Stress 2003; 16(3): 301-6.
[20]
Blanco C, Xu Y, Brady K, Pérez-Fuentes G, Okuda M, Wang S. Comorbidity of posttraumatic stress disorder with alcohol dependence among US adults: results from National Epidemiological Survey on Alcohol and Related Conditions. Drug Alcohol Depend 2013; 132(3): 630-8.
[21]
Rivara FP, Jurkovich GJ, Gurney JG, et al. The magnitude of acute and chronic alcohol abuse in trauma patients. Arch Surg 1993; 128(8): 907-12.
[http://dx.doi.org/10.1001/archsurg.1993.01420200081015] [PMID: 8102049]
[22]
Stewart SH. Alcohol abuse in individuals exposed to trauma: a critical review. Psychol Bull 1996; 120(1): 83-112.
[http://dx.doi.org/10.1037/0033-2909.120.1.83] [PMID: 8711018]
[23]
Vujanovic AA, Back SE. Posttraumatic stress and substance use disorders. New York: Taylor and Francis 2019.
[24]
Bountress KE, Cusack SE, Sheerin CM, et al. Alcohol consumption, interpersonal trauma, and drinking to cope with trauma-related distress: an auto-regressive, cross-lagged model. Psychol Addict Behav 2019; 33(3): 221-31.
[http://dx.doi.org/10.1037/adb0000457] [PMID: 30869917]
[25]
Anda RF, Brown DW, Felitti VJ, Bremner JD, Dube SR, Giles WH. Adverse childhood experiences and prescribed psychotropic medications in adults. Am J Prev Med 2007; 32(5): 389-94.
[http://dx.doi.org/10.1016/j.amepre.2007.01.005] [PMID: 17478264]
[26]
Keeshin BR, Strawn JR, Luebbe AM, et al. Hospitalized youth and child abuse: a systematic examination of psychiatric morbidity and clinical severity. Child Abuse Negl 2014; 38(1): 76-83.
[http://dx.doi.org/10.1016/j.chiabu.2013.08.013] [PMID: 24041456]
[27]
Guha A, Luebbers S, Papalia N, Ogloff JRP. A follow-up study of mental health service utilisation in a cohort of 2433 sexually abused Australian children utilising five years of medical data. Child Abuse Negl 2019; 90: 174-84.
[http://dx.doi.org/10.1016/j.chiabu.2019.01.015] [PMID: 30798015]
[28]
Derefinko KJ, Salgado García FI, Talley KM, et al. Adverse childhood experiences predict opioid relapse during treatment among rural adults. Addict Behav 2019; 96: 171-4.
[http://dx.doi.org/10.1016/j.addbeh.2019.05.008] [PMID: 31102882]
[29]
King AR, Kuhn S, Jowkar M, Smith K. Self-reported health profiles of trauma victims with and without psychiatric histories. Annual Northern Lights Conference. Grand Forks, N.D..
[30]
Buhrmester M, Kwang T, Gosling SD. Amazon’s Mechanical Turk: a new source of inexpensive, yet high-quality, data? Perspect Psychol Sci 2011; 6(1): 3-5.
[http://dx.doi.org/10.1177/1745691610393980] [PMID: 26162106]
[31]
Gosling SD, Vazire S, Srivastava S, John OP. Should we trust web-based studies? A comparative analysis of six preconceptions about internet questionnaires. Am Psychol 2004; 59(2): 93-104.
[http://dx.doi.org/10.1037/0003-066X.59.2.93] [PMID: 14992636]
[32]
Paolacci G, Chandler J, Ipeirotis P. Running experiments on Amazon Mechanical Turk. Judgm Decis Mak 2010; 5: 411-9.
[http://dx.doi.org/10.1177/0963721414531598]
[33]
Kennedy R, Clifford S, Burleigh T, Waggoner P, Jewell R. The shape of and solutions to the MTurk quality crisis Available from: www.researchgate.net/publication/328580368_The_Shape_
[http://dx.doi.org/10.2139/ssrn.3272468]
[34]
Litman L. Concerns about bots on Mechanical Turk: Problems and Solutions. Available from: https://blog.turkprime.com/concerns-about-bots-on-mechanical-turk-problems-2018
[35]
Winter NJG, Burleigh T, Kennedy R, Clifford S. A simplified protocol to screen out VPS and international respondents using qualtrics Available from: https://ssrn.com/abstract=3327274
[http://dx.doi.org/10.2139/ssrn.3327274]

© 2024 Bentham Science Publishers | Privacy Policy