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

Shiner, Brian MD, MPH*†; Bateman, Daniel MD; Young-Xu, Yinong ScD†‡; Zayed, Maha PhD*; Harmon, A. Lisa PhD*†; Pomerantz, Andrew MD*†; Watts, Bradley V. MD, MPH†‡

The Journal of Nervous and Mental Disease: June 2012 - Volume 200 - Issue 6 - p 520–525
doi: 10.1097/NMD.0b013e318257c6da
Original Article

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.

*VA Medical Center, White River Junction, VT; †Department of Psychiatry, Dartmouth Medical School, Hanover, NH; and ‡VA National Center for Patient Safety, White River Junction, VT.

This study was approved by the White River Junction Veterans Affairs Medical Center Research and Development Committee. A waiver of consent was provided by the Dartmouth College Center for the Protection of Human Subjects (CPHS 21631).

Send reprint requests to Brian Shiner, MD, MPH, White River Junction VA Medical Center, 215 North Main Street (11Q), White River Junction, VT 05009. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.