The British Journal of Psychiatry (2009) 194: 515-520. doi: 10.1192/bjp.bp.108.054700
© 2009 The Royal College of Psychiatrists
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Delayed-onset post-traumatic stress disorder among war veterans in primary care clinics

B. Christopher Frueh

The Menninger Clinic and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA

Anouk L. Grubaugh, Derik E. Yeager and Kathryn M. Magruder

Veterans Affairs Medical Center and Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA

Correspondence: B. Christopher Frueh, Department of Psychology, University of Hawaii, 200 W. Kawili St., Hilo, HI 96720, USA. Email: frueh{at}hawaii.edu

Declaration of interest

None.

Funding

This work was partially supported by grants VCR-99-010-2 from Veterans Affairs Health Services Research and Development (Veterans Affairs HSR&D) to K.M.M., grant CD-207015 from Veterans Affairs HSR&D to A.L.G., grant MH074468 from the National Institute of Mental Health (NIMH) to B.C.F and awards from the McNair Foundation and Menninger Foundation. This work was also supported by the Office of Research and Development, Medical Research Service, Department of Veterans Affairs. All views and opinions expressed herein are those of the authors and do not necessarily reflect those of our respective institutions or the Department of Veterans Affairs.

Background

Only limited empirical data support the existence of delayed-onset post-traumatic stress disorder (PTSD).

Aims

To expand our understanding of delayed-onset PTSD prevalence and phenomenology.

Method

A cross-sectional, epidemiological design (n = 747) incorporating structured interviews to obtain relevant information for analyses in a multisite study of military veterans.

Results

A small percentage of veterans with identified current PTSD (8.3%, 7/84), current subthreshold PTSD (6.9%, 2/29), and lifetime PTSD only (5.4%, 2/37) met criteria for delayed onset with PTSD symptoms initiating more than 6 months after the index trauma. Altogether only 0.4% (3/747) of the entire sample had current PTSD with delayed-onset symptoms developing more than 1 year after trauma exposure, and no PTSD symptom onset was reported more than 6 years post-trauma.

Conclusions

Retrospective reports of veterans reveal that delayed-onset PTSD (current, subthreshold or lifetime) is extremely rare 1 year post-trauma, and there was no evidence of PTSD symptom onset 6 or more years after trauma exposure.


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