Longitudinal patterns of care for patients with posttraumatic stress disorder

This study assessed patterns of mental health service use over time by patients with posttraumatic stress disorder (PTSD) — as compared with patients with schizophrenia and major depression — with emphasis on the persistence and episodic versus continuous nature of use. Data on utilization were extracted from Veterans Health Administration (VA) administrative data bases. Temporal patterns of use were categorized into intervals of inpatient, outpatient, and no use. PTSD patients used substantial amounts of mental health services, but averaged 2.2 nonuse intervals lasting more than 100 days each, implying that use was episodic. Use of mental health services by patients with PTSD is substantial, persistent, and quite episodic. To the extent that use of services reflects the course of the disorder, the results suggest that remissions are usually followed by relapse, and that absence of symptoms does not mean that the disorder has run its course.