Saunders Elizabeth C, Lambert-Harris Chantal, McGovern Mark P, Meier Andrea, Xie Haiyi
a Research Assistant, Dartmouth Psychiatric Research Center , Lebanon , NH.
J Psychoactive Drugs. 2015 Jan-Mar;47(1):42-50. doi: 10.1080/02791072.2014.977501.
Co-occurring cocaine use and posttraumatic stress disorders are prevalent and associated with negative treatment, health and societal consequences. This study examined the relationships among PTSD symptoms, gender, and cocaine use problems. Within a cross-sectional design, we gathered archival point prevalence data on new admissions (n = 573) to three addiction treatment agencies. Demographic, substance use, and PTSD symptom information were collected across the three agencies. Logistic regression analyses revealed that patients with cocaine use disorders had a two-fold increased odds for a probable PTSD diagnosis, compared to patients without a cocaine use disorder (OR = 2.19, 95% CI = 1.49-3.22, p < 0.001). Among females with cocaine use disorder, multinomial regression yielded a significant increase in the risk of moderate (RRR = 2.12, 95% CI = 1.10-4.10, p < 0.05) and severe (RRR = 2.87, 95% CI = 1.33-6.21, p < 0.01) PTSD symptoms. Males with cocaine use disorders had a two-fold increase in the risk of moderate PTSD symptoms (RRR = 2.13, 95% CI = 1.23-3.68, p < 0.01), but had no increased risk of developing severe PTSD symptoms (RRR = 1.93, 95% CI = 0.85-4.39, p = 0.117). Cocaine use appears to impact the risk of PTSD symptoms, especially in females. Future research should explore the generalizability of these findings to more racially and ethnically diverse samples, as well as among persons with this comorbidity who are not engaged in treatment services.
同时使用可卡因和创伤后应激障碍很常见，且与负面的治疗、健康和社会后果相关。本研究考察了创伤后应激障碍症状、性别和可卡因使用问题之间的关系。在横断面设计中，我们收集了三家成瘾治疗机构新入院患者（n = 573）的档案时点患病率数据。在这三家机构中收集了人口统计学、物质使用和创伤后应激障碍症状信息。逻辑回归分析显示，与没有可卡因使用障碍的患者相比，患有可卡因使用障碍的患者被诊断为可能患有创伤后应激障碍的几率增加了两倍（OR = 2.19，95% CI = 1.49 - 3.22，p < 0.001）。在患有可卡因使用障碍的女性中，多项回归显示中度（RRR = 2.12，95% CI = 1.10 - 4.10，p < 0.05）和重度（RRR = 2.87，95% CI = 1.33 - 6.21，p < 0.01）创伤后应激障碍症状的风险显著增加。患有可卡因使用障碍的男性中度创伤后应激障碍症状的风险增加了两倍（RRR = 2.13，95% CI = 1.23 - 3.68，p < 0.01），但发生重度创伤后应激障碍症状的风险没有增加（RRR = 1.93，95% CI = 0.85 - 4.39，p = 0.117）。使用可卡因似乎会影响创伤后应激障碍症状的风险，尤其是在女性中。未来的研究应该探讨这些发现对更多种族和族裔多样化样本的可推广性，以及在未接受治疗服务的这种共病患者中的情况。
