Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland.
Department of Psychiatry, CHUV, Lausanne, Switzerland.
Psychiatry Res. 2015 Aug 30;228(3):251-6. doi: 10.1016/j.psychres.2015.06.034. Epub 2015 Jun 27.
There is much evidence that alcohol use disorders (AUD) often co-occur with posttraumatic stress disorders (PTSD), and that the comorbid condition is associated with a more severe clinical profile than that of PTSD without AUD. However, little is known about the role of childhood adversities as specific risk factors for the development of AUD in individuals presenting with PTSD. The aim of the study was to explore whether specific stressors from the spectrum of trauma and childhood adversities contribute to the development of AUD among subjects with PTSD. From a large community sample, of N=140 individuals with PTSD, N=24 (17.14%) received an additional diagnosis of AUD with an onset after the onset of PTSD. Those with comorbid PTSD/AUD and those with PTSD only were compared regarding type and features of their trauma, childhood adversities and psychiatric comorbidity. Compared to PTSD alone, PTSD/AUD was associated with higher levels of stress in terms of childhood adversities; in particular, sexual abuse below the age of 16, but also with having been brought up in a foster home. PTSD/AUD was also associated with an earlier age of adverse events. Treatment of AUD should include standardized assessments of trauma, especially of trauma experienced during childhood.
有大量证据表明，酒精使用障碍（AUD）常与创伤后应激障碍（PTSD）共病，且共病状态与无 AUD 的 PTSD 相比具有更严重的临床特征。然而，对于童年逆境作为 PTSD 患者 AUD 发展的特定风险因素的作用知之甚少。本研究旨在探讨 PTSD 患者中，来自创伤和童年逆境范围内的特定应激源是否会导致 AUD 的发展。在一个包含 N=140 名 PTSD 患者的大型社区样本中，N=24（17.14%）在 PTSD 发病后被诊断出 AUD。对共病 PTSD/AUD 和仅有 PTSD 的患者进行比较，比较他们的创伤类型和特征、童年逆境和精神共病情况。与单纯 PTSD 相比，PTSD/AUD 与童年逆境方面的更高水平的应激有关；特别是 16 岁以下的性虐待，以及在寄养家庭中长大。PTSD/AUD 还与不良事件发生的年龄更早有关。AUD 的治疗应包括对创伤的标准化评估，尤其是儿童时期经历的创伤。
Pharmacol Biochem Behav. 2020-9
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