Back Sudie E, Jackson Joan L, Sonne Susan, Brady Kathleen T
Department of Psychology, University of Georgia, Athens, GA 30606, USA.
J Subst Abuse Treat. 2005 Jul;29(1):29-37. doi: 10.1016/j.jsat.2005.03.002.
Alcohol dependence (AD) and posttraumatic stress disorder (PTSD) frequently co-occur. However, little systematic study has examined the importance of their temporal order of onset. In this study, differences in clinical presentation and response to cognitive-behavioral substance-use therapy by order of onset were examined among 94 (51 men and 43 women) individuals with AD and PTSD. The findings revealed that women with primary AD and men with primary PTSD presented as more distressed and/or depressed than their counterparts at treatment entry. A relationship between increased alcohol intake and higher PTSD symptom levels was observed during treatment. In general, the primary PTSD group derived greater overall benefit (e.g., in physical health, alcohol use, social functioning) as compared with the primary AD group. Finally, women with primary AD appeared particularly vulnerable to continued psychiatric distress and depression at the end of treatment. These findings increase awareness of the importance of considering the order of onset and may ultimately lead to treatment improvements for this population.
酒精依赖（AD）和创伤后应激障碍（PTSD）经常同时出现。然而，很少有系统的研究探讨它们发病时间顺序的重要性。在本研究中，对94名（51名男性和43名女性）患有AD和PTSD的个体，按发病顺序研究了临床表现以及对认知行为物质使用疗法反应的差异。研究结果显示，在治疗开始时，原发性AD的女性和原发性PTSD的男性比其对应组表现出更多的痛苦和/或抑郁。在治疗期间观察到酒精摄入量增加与更高的PTSD症状水平之间存在关联。总体而言，与原发性AD组相比，原发性PTSD组在总体上获得了更大的益处（例如，在身体健康、酒精使用、社会功能方面）。最后，原发性AD的女性在治疗结束时似乎特别容易持续出现精神困扰和抑郁。这些发现提高了对考虑发病顺序重要性的认识，并最终可能导致针对这一人群的治疗改进。
