Nearly one-third of veterans who experience trauma are at a higher risk for depression, substance abuse or suicide even though they do not meet all the criteria for a post-traumatic stress disorder (PTSD) diagnosis. The findings of a Yale study highlight the need for doctors to be vigilant when assessing and treating PTSD symptoms in veterans who have suffered trauma.
PTSD symptoms consist of negative thoughts and feelings, increased anger, avoidance patterns, being easily startled, recurring memories of traumatic events, hyperarousal, difficulty concentrating and trouble sleeping. Veterans must have all of these symptoms in order to be diagnosed with PTSD. In addition, the symptoms must meet certain criteria of severity and duration.
The study examined 1,484 veterans for subthreshold PTSD. The condition refers to a group of symptoms that are not severe or complete enough to warrant a PTSD diagnosis. Among the participants, 8 percent were diagnosed with PTSD while 22.1 percent of the traumatized veterans met subthreshold PTSD criteria. Those who experienced the latter had higher rates of mental health problems. For example, veterans with subthreshold PTSD had nearly five times the chance of suffering depression in comparison with those who did not have symptoms.
Some researchers believe subthreshold PTSD is an overlooked trigger for a range of mental health disorders. Clinical psychologist Robert Pietrzak, the study’s senior author and director of the Translational Psychiatric Epidemiology Laboratory of the Clinical Neurosciences Division at the U.S. Department of Veterans Affairs National Center for PTSD, described the findings as “striking.” He said, “We found three, four, five times higher rates of some disorders in veterans with subthreshold PTSD … You have a very large group of people who may be in need of treatment, but are often overlooked in clinical settings.”