Center of Excellence in Substance Abuse and Treatment (CESATE), VA Puget Sound Health Care System, Seattle, WA, USA.
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
Addiction. 2019 Jun;114(6):983-993. doi: 10.1111/add.14565. Epub 2019 Mar 10.
To compare individuals with comorbid life-time post-traumatic stress disorder (PTSD) and alcohol use disorders [AUD; i.e. no drug use disorders (DUD)] with those with comorbid PTSD and DUD on past-year prevalence of these disorders, social functioning, life-time psychiatric comorbidities, and treatment receipt. The comorbid groups were also compared with their single diagnosis counterparts.
Cross-sectional cohort study using data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC-III).
The total sample size was 36 309. Six groups were established: PTSD/AUD, PTSD/DUD, AUD, DUD, PTSD, and neither PTSD nor AUD/DUD. Life-time prevalence of AUD among those with PTSD/DUD was 80.2% and among those with DUD was 73.8%.
The Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-5 version assessed life-time and past-year psychiatric disorders and treatment receipt. Demographics and social stability indicators were queried. Group characteristics were summarized using weighted means. Prevalences and estimates for adjusted differences in means and adjusted odds ratios (aORs) were derived from multiple linear regression and logistic regression models, respectively. Analyses were conducted in R and accounted for the NESARC-III's complex survey design, clustering, and non-response.
Compared with those with life-time PTSD/AUD, those with life-time PTSD/DUD were significantly less likely to have neither disorder in the past year (PTSD/AUD = 16.1%; PTSD/DUD = 8.5%; aOR = 0.54), and were more likely to report worse social and psychiatric functioning, and to have received both addiction and mental health treatment (PTSD/AUD = 18.4%; PTSD/DUD = 43.2%; aOR = 3.88). Compared with their single disorder counterparts, those with PTSD/DUD reported greater impairment than both groups, whereas the comorbid PTSD/AUD group differed more from the AUD than the PTSD group.
People with comorbid PTSD and drug use disorder have greater social and psychiatric impairment and may require different types and intensity of intervention than people with comorbid post-traumatic stress disorder and alcohol use disorder.
比较同时患有创伤后应激障碍（PTSD）和酒精使用障碍（AUD；即无药物使用障碍[DUD]）与同时患有 PTSD 和 DUD 的个体在过去一年这些障碍的患病率、社会功能、终生精神共病和治疗情况。还将共病组与他们的单一诊断对照组进行比较。
使用国家酒精相关情况流行病学调查（NESARC-III）的数据进行的横断面队列研究。
总样本量为 36309 人。建立了六个组：PTSD/AUD、PTSD/DUD、AUD、DUD、PTSD 和 PTSD 及 AUD/DUD 均无。PTSD/DUD 中的终生 AUD 患病率为 80.2%，DUD 中为 73.8%。
酒精使用障碍和相关残疾访谈表-DSM-5 版本评估了终生和过去一年的精神障碍和治疗情况。询问了人口统计学和社会稳定性指标。使用加权平均值总结了组特征。从多线性回归和逻辑回归模型中得出了调整后的均值差异的患病率和调整后的优势比（aOR）的估计值。分析在 R 中进行，并考虑了 NESARC-III 的复杂调查设计、聚类和无应答情况。
与终生 PTSD/AUD 相比，终生 PTSD/DUD 者在过去一年中两种疾病均无的可能性明显较低（PTSD/AUD = 16.1%；PTSD/DUD = 8.5%；aOR = 0.54），且更有可能报告社会和精神功能更差，且接受过成瘾和心理健康治疗（PTSD/AUD = 18.4%；PTSD/DUD = 43.2%；aOR = 3.88）。与他们的单一疾病对照组相比，PTSD/DUD 报告的障碍比两组都大，而 PTSD/AUD 组与 AUD 组的差异大于 PTSD 组。
同时患有 PTSD 和药物使用障碍的人社会和精神功能障碍更严重，可能需要不同类型和强度的干预，而不是同时患有 PTSD 和酒精使用障碍的人。
