![]() In addition, recent issues like COVID-19, civil unrest, and climate change continue to occur around the globe, adding to the growing concern of increased exposure to natural and societal traumatic events among civilians. However, this represents a minority (14%) of the overall PTSD population in the US, with 86% of the PTSD population comprising civilians. Historically, PTSD has been predominantly studied among military individuals, likely due to the high prevalence of PTSD in this population. The 1-year prevalence of PTSD is estimated at 2.6 to 6.0% in civilians and 6.7 to 11.7% in military populations, and is twice as common among women compared to men. In addition, PTSD is associated with a substantial economic burden to society, with a recent study estimating the burden at $232.2 billion in the United States (US). ![]() The psychosocial impact of PTSD on patients is substantial, with increased risk of suicide attempts, disability and unemployment, and comorbid conditions such as depression and substance use disorder. These symptom clusters are associated with the traumatic event and include intrusive and recurrent memories, avoidance of trauma-related stimuli, negative mood or cognitions, and marked arousal and reactivity. Post-traumatic stress disorder (PTSD) is characterized by the presence of four clusters of symptoms that may present after experiencing or witnessing a traumatic event. These findings suggest that the lack of a PTSD diagnosis and targeted management of PTSD may result in a greater burden among undiagnosed patients and highlights the need for increased awareness of PTSD in clinical practice and among the civilian population. Mean per-patient-per-6-month healthcare costs were similar between the Actual Positive and Likely PTSD cohorts ($11,156 and $11,723) and were higher than those of the Without PTSD cohort ($3616) however, cost drivers differed between cohorts, with the Likely PTSD cohort experiencing more inpatient admissions and less outpatient visits than the Actual Positive PTSD cohort. While several symptoms/comorbidities were similar between the Actual Positive and Likely PTSD cohorts, others, including depression and anxiety disorders, suicidal thoughts/actions, and substance use, were more common in the Likely PTSD cohort, suggesting that certain symptoms may be exacerbated among those without a formal diagnosis. ResultsĪ total of 44,342 patients were classified in the Actual Positive PTSD cohort, 5683 in the Likely PTSD cohort, and 2,074,471 in the Without PTSD cohort. Patient characteristics, symptoms and complications potentially related to PTSD, treatments received, healthcare costs, and healthcare resource utilization were described separately for patients with PTSD (Actual Positive PTSD cohort), patients likely to have PTSD (Likely PTSD cohort), and patients without PTSD (Without PTSD cohort). The model was applied to patients for whom PTSD status could not be confirmed to identify individuals likely and unlikely to have undiagnosed PTSD. A random forest machine learning model was developed and trained to differentiate between patients with and without PTSD using non–trauma-based features. ![]() The IBM® MarketScan® Commercial Subset (–) was used. This study used a machine learning approach to identify and describe civilian patients likely to have undiagnosed PTSD in the US commercial population. Without an accurate diagnosis, these patients may lack PTSD-targeted treatments and experience adverse health outcomes. The proportion of patients with post-traumatic stress disorder (PTSD) that remain undiagnosed may be substantial.
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