Assault and mental disorders: A cross-sectional study of urban adult primary care patients

Objective: This study estimated the strength of associations between self-reported assault and psychiatric disorders among low-income, urban primary care patients who were predominantly female. Methods: A sample of adult patients who consecutively presented at an urban primary care practice completed the Life Events Checklist (N=1,157). They were also screened for current major depression, panic disorder, generalized anxiety disorder, and substance use disorders with the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire; for bipolar disorder with the Mood Disorder Questionnaire; and for posttraumatic stress disorder (PTSD) with the PTSD Checklist-Civilian Version. A total of 977 of the respondents reported whether they had ever experienced an assault. Logistic regression was used to model associations between self-reported assault and screen status, controlling for relevant sociodemographic and clinical characteristics. Results: Twenty-five percent of study participants endorsed a history of physical or sexual assault. Compared with patients without a history of assault, patients with a history of assault had significantly greater odds of screening positive for PTSD (odds ratio [OR]=1.97, 95% confidence interval [CI]=1.19-3.25), alcohol use disorder (OR=2.17, CI=1.07-4.41), and drug use disorder (OR=3.38, CI=1.14-9.98). Conclusion: A history of assault was related to risk of screening positive for PTSD and a substance use disorder. These findings support assessment of trauma history among low-income primary care patients.