Department of Psychology, LMU Munich, Leopoldstraße 13, 80802, Munich, Germany.
Department of Psychiatry and Psychotherapy, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany.
Drug Alcohol Depend. 2021 Jun 1;223:108709. doi: 10.1016/j.drugalcdep.2021.108709. Epub 2021 Apr 20.
Substance use disorder (SUD) and posttraumatic stress disorder (PTSD) are highly comorbid. Self-medication hypothesis (SMH) is a seminal theory aiming to account for the relationship between these disorders. The current study examined hypotheses based on SMH in SUD patients during the very first days of detoxification. Based on SMH we expected a positive association between PTSD and craving concurrently as well as on each following day.
A time series with 108 SUD patients used daily self-report questionnaires assessing PTSD symptom severity (PCL-5) and craving (MaCs) for six consecutive days. Daily associations between PTSD symptom severity and craving on the same and on the following day during the first week of detoxification were estimated using linear mixed models.
There was a significant decrease in PTSD symptom severity during detoxification (ß = -2.06, p < 0.001). Further, PTSD symptom severity predicted craving on the same day (ß = 0.36, p < 0.001) but did not predict craving on the next day (ß = -0.01, p = 0.82).
Results of the current study only partially support assumptions based on SMH, and points towards a more complex and reciprocal relationship between PTSD and SUD.
物质使用障碍（SUD）和创伤后应激障碍（PTSD）高度共病。自我用药假说（SMH）是一种重要理论，旨在解释这两种疾病之间的关系。本研究在 SUD 患者解毒的最初几天内检验了基于 SMH 的假设。基于 SMH，我们预计 PTSD 和渴望之间会同时存在正相关，并且在接下来的每一天也会存在正相关。
一项时间序列研究纳入了 108 名 SUD 患者，他们在解毒的连续六天内每天使用自我报告问卷评估 PTSD 症状严重程度（PCL-5）和渴望程度（MaCs）。使用线性混合模型估计解毒第一周内同一天和下一天 PTSD 症状严重程度与渴望之间的每日关联。
在解毒过程中，PTSD 症状严重程度显著下降（ß = -2.06，p < 0.001）。此外，PTSD 症状严重程度预测了当天的渴望（ß = 0.36，p < 0.001），但未预测次日的渴望（ß = -0.01，p = 0.82）。
本研究结果仅部分支持基于 SMH 的假设，表明 PTSD 和 SUD 之间存在更复杂和相互影响的关系。
