Debell Frances, Fear Nicola T, Head Marc, Batt-Rawden Samantha, Greenberg Neil, Wessely Simon, Goodwin Laura
King's College London School of Medicine, Hodgkin Building, Guy's Campus, London, SE1 1UL, UK.
Soc Psychiatry Psychiatr Epidemiol. 2014 Sep;49(9):1401-25. doi: 10.1007/s00127-014-0855-7. Epub 2014 Mar 19.
This systematic review aimed to assess (1) the level of comorbidity of post-traumatic stress disorder (PTSD) and alcohol misuse reported in research studies since 2007 and (2) any associations found between specific PTSD symptom clusters and alcohol misuse.
A literature search was carried out to capture any papers published from 2007 to the end of July 2012. Six hundred and twenty abstracts were identified and reviewed, and 42 papers were included in the final review after applying inclusion and exclusion criteria.
The prevalence of comorbid alcohol misuse in those with PTSD ranged from 9.8 to 61.3 %. The prevalence of comorbid PTSD in those with alcohol misuse ranged from 2.0 to 63.0 %, and the majority of prevalence rates were over 10.0 %. Almost all of the odds ratios representing the strength of association between the conditions across a variety of populations were significant, and those ranged from 1.1 to 4.87. Of the different PTSD symptom clusters, this review found most evidence for associations between alcohol misuse and both avoidance/numbing symptoms and hyperarousal symptoms.
Given that comorbidity appears to be common, the evidence from this systematic review supports the use of routine screening for comorbidity in populations who are known to have PTSD or alcohol misuse.
本系统评价旨在评估:(1)2007年以来研究报告中创伤后应激障碍(PTSD)与酒精滥用的共病水平;(2)特定PTSD症状群与酒精滥用之间发现的任何关联。
进行文献检索以获取2007年至2012年7月底发表的任何论文。共识别并审阅了620篇摘要,应用纳入和排除标准后,最终纳入42篇论文进行综述。
PTSD患者中酒精滥用共病的患病率为9.8%至61.3%。酒精滥用患者中PTSD共病的患病率为2.0%至63.0%,大多数患病率超过10.0%。几乎所有代表不同人群中这些疾病之间关联强度的优势比均具有统计学意义,范围为1.1至4.87。在不同的PTSD症状群中,本综述发现酒精滥用与回避/麻木症状和过度警觉症状之间存在关联的证据最多。
鉴于共病似乎很常见,本系统评价的证据支持对已知患有PTSD或酒精滥用的人群进行共病的常规筛查。