PTSD and substance use: unrecognized sequelae of bioterrorism in primary care providers

South Med J. 2006 Aug;99(8):817-22. doi: 10.1097/01.smj.0000231261.99126.51.


Background: Psychological casualties following public health emergencies are likely to significantly outnumber physical casualties. However, postevent psychological disorders may be underrecognized by primary care providers (PCPs).

Methods: Rural PCPs in northern and central Florida were interviewed using a series of open-ended questions to assess knowledge of likely mental disorders, their risk factors, and preferred treatment options following such events (n=21).

Results: PTSD was identified by 14% and substance abuse by 10% of the sample. Physicians were significantly more likely to identify posttraumatic stress disorder (PTSD) as an expected postevent psychological disorder than nonphysician providers. PCPs were significantly more likely to endorse counseling (86%) than medications (43%) as a preferred treatment option.

Conclusions: Our findings support the need for increased education and training regarding the mental health consequences of bioterrorism in rural PCPs, particularly for nursing-level and other nonphysician providers. Improvements in knowledge may enhance preparedness for such emergencies.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Bioterrorism*
  • Female
  • Florida / epidemiology
  • Health Knowledge, Attitudes, Practice*
  • Health Personnel / standards*
  • Humans
  • Incidence
  • Male
  • Mental Health
  • Middle Aged
  • Primary Health Care*
  • Rural Population
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / etiology*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / etiology*