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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

November 2016

Diagnosing PTSD and Referral for Treatment


With Veterans Day just having passed, the prevalence of post-traumatic stress disorder (PTSD) is fresh in the national consciousness. The effects are far-reaching among veterans and civilians alike, with the disorder affecting about 7.7 million American adults. PTSD may result from experiencing a disturbing ordeal directly or from witnessing a traumatic event, such as wartime violence, rape, child abuse, an act of terrorism, a natural disaster, or a car, train, or airplane crash.

Symptoms of PTSD typically begin within three months of an incident, but they have been known to manifest themselves years later. Not every person involved in a trauma develops PTSD, and it’s unclear why some individuals develop the condition and others do not. However, the following factors may influence how susceptible an individual is:

  • Degree of intensity of the traumatic event
  • Whether a loved one was lost or hurt
  • Proximity to the event
  • How much control the patient perceived he or she had over or during the event
  • Support and assistance received after the trauma

Initially, a person who experienced a traumatic event may feel only numbness and shock. As time goes on, however, other feelings emerge, and many individuals with PTSD replay the event over and over in their minds, creating different scenarios about what they could have done differently. Often, they can’t forget the feelings of terror, helplessness, and the loss of control they felt at the time. Different patients’ reactions to trauma vary greatly, and symptoms of PTSD may present themselves in numerous different ways after a traumatic event; common examples include:
  • Emotional symptoms: depression, helplessness, fear, anxiety, anger, frustration, or grief
  • Behavioral symptoms: social withdrawal, loss of interest in activities, or increased use of alcohol or drugs
  • Cognitive symptoms: poor concentration, poor job performance, confusion, or forgetfulness 
  • Physical symptoms: changes in appetite, headaches, insomnia, nightmares, fatigue, or tension

Deliberate violence, such as an act of terrorism or rape, often creates longer lasting mental health effects than do natural disasters, such as earthquakes or hurricanes. The effect of acts of terrorism may be widespread, creating a mass trauma and affecting those directly and indirectly involved.

Keep in mind that a patient with PTSD may first report physical symptoms such as sleeplessness or indigestion. The care for a patient diagnosed with PTSD will likely involve collaboration between the PCP, the patient, behavioral health practitioners, and the patient’s family members. If a Harvard Pilgrim member is displaying symptoms of PTSD, Optum/UBH can help with diagnosis and treatment.

How Optum/UBH can help your patients — For complex clinical situations, Optum/UBH is available to provide consultative assistance. Practitioners can call the Optum/UBH Physicians Consultation Service at 800-292-2922. To refer a patient for behavioral health services and to facilitate the coordination of care, call Optum at 888-777-4742.

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    Eric H. Schultz,
    President and Chief Executive Officer

    Robert Farias,
    Vice President, Network Services

    Annmarie Dadoly,
    Editor

    Joseph O'Riordan,
    Writer

    Kristin Edmonston,
    Production Coordinator