Norman Sonya B, Tate Susan R, Anderson Kristen G, Brown Sandra A
University of California, San Diego and VA San Diego Healthcare System, McGill Hall, La Jolla, CA 92093-0109, USA.
Drug Alcohol Depend. 2007 Sep 6;90(1):89-96. doi: 10.1016/j.drugalcdep.2007.03.002. Epub 2007 Apr 24.
Exposure to traumatic events is common among individuals with substance use disorders (SUD), although not all go on to develop PTSD. We compared SUD treatment outcomes and relapse features in three groups of male veterans receiving SUD treatment: (1) those without trauma exposure (SUD-only; n=68), (2) those with PTSD (SUD-PTSD; n=32), and (3) those with trauma exposure but no PTSD (SUD-trauma; n=34). Veterans were assessed regarding psychiatric symptoms, substance use, and relapse features quarterly for 1 year. The groups did not differ on length of abstinence, relapse prevalence or severity. SUD-PTSD and SUD-trauma reported more depression, anxiety, PTSD, and total psychiatric symptoms prior to relapse than SUD-only. SUD-PTSD and SUD-trauma also endorsed more PTSD, and total symptoms following relapse than SUD-only. PTSD symptoms were associated with greater risk of relapse in intrapersonal and negative physiological contexts. Understanding relapse contexts for those experiencing PTSD symptoms can help us to understand one mechanism whereby those with both PTSD and SUD have a poorer clinical course.
遭受创伤性事件在患有物质使用障碍（SUD）的个体中很常见，尽管并非所有人都会发展为创伤后应激障碍（PTSD）。我们比较了三组接受SUD治疗的男性退伍军人的SUD治疗结果和复发特征：（1）无创伤暴露者（仅SUD；n = 68），（2）患有PTSD者（SUD-PTSD；n = 32），以及（3）有创伤暴露但无PTSD者（SUD-创伤；n = 34）。对退伍军人的精神症状、物质使用和复发特征进行了为期1年的季度评估。三组在戒断时间、复发患病率或严重程度方面没有差异。与仅SUD组相比，SUD-PTSD组和SUD-创伤组在复发前报告了更多的抑郁、焦虑、PTSD和总精神症状。与仅SUD组相比，SUD-PTSD组和SUD-创伤组在复发后也认可了更多的PTSD和总症状。在人际和负面生理背景下，PTSD症状与更高的复发风险相关。了解有PTSD症状者的复发背景可以帮助我们理解PTSD和SUD患者临床病程较差的一种机制。
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