Objective: To examine among immigrants and others seeking primary care: (1)
the prevalence, types, and predictors of traumatic life events; and (2) th
e relations among traumatic life events, psychiatric disorders, and utiliza
tion of primary care services.
Design: Survey with structured diagnostic interview.
Setting: Community-based, university-affiliated primary care clinic in sout
hern California.
Participants: Fourteen hundred fifty-six adult patients representing 4 ethn
ic groups (Mexican immigrants, Central American immigrants, US-born Latinos
of Mexican descent, and US-born non-Latino whites).
Dependent Measures: Rates of traumatic events measured with the Posttraumat
ic Stress Disorder section of the Diagnostic Interview Schedule; psychiatri
c disorders identified by the Composite International Diagnostic Interview
using Diagnostic and Statistical Manual of Mental Disorders, Revised Third
Edition criteria; physical functioning (Short Form Health Survey); and the
number of medical clinic visits during a g-month period.
Results: Nearly 10% of patients had experienced a traumatic event in the pr
evious year, and 57% had experienced at least 1 during their lifetimes. The
most common forms of trauma were interpersonal violence occurring outside
the family (21%), acute losses or accidents (17%), witnessing death or viol
ence (13%), and domestic violence (12%). When compared with the US-born non
-Latino whites, Mexican immigrants were half as likely, and Central America
n immigrants were 76% more likely, to report having experienced a traumatic
event. Married individuals were significantly less likely to report trauma
s. Traumatic experiences, female gender, and non-Latino ethnicity were asso
ciated with the presence of a psychiatric disorder. One-year and lifetime p
sychiatric disorders were associated with poorer physical functioning and a
n increased number of clinic visits during a 6-month period.
Conclusions: Traumatic life events are common and associated with psychiatr
ic disorders other than posttraumatic stress disorder in an ethnically dive
rse sample of primary care patients. Psychiatric disorders, in turn, are st
rongly associated with poor physical functioning and higher rates of primar
y care utilization. Screening for traumatic experiences should accompany as
sessments of psychiatric disorders to ensure adequate treatment of patients
seeking primary care services.