Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States.
Addict Behav. 2023 Apr;139:107592. doi: 10.1016/j.addbeh.2022.107592. Epub 2022 Dec 21.
The co-occurrence of substance use disorder (SUD) and posttraumatic stress disorder (PTSD) is common, and is associated with greater severity of symptoms, poorer treatment prognosis, and increased risk of return to substance use following treatment. Screening for PTSD is not routinely implemented in substance use treatment programs, despite clinical relevance. Identifying screening tools that minimize patient burden and allow for comprehensive treatment in this patient population is critical. The current study examined the utility of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) in identifying probable PTSD in a predominantly Black sample of 81 socioeconomically disadvantaged substance misusing hospital patients. The majority of the sample (75.3 %; n = 61) were found to meet criteria for probable PTSD using a suggested clinical cut score of 33 on the PTSD Checklist for DSM-5 (PCL-5). Diagnostic utility analyses were completed and determined a cut-score of 5 for the PC-PTSD-5 to demonstrate the best performance (SE = 0.62, κ(1) = 0.22; SP =.80, κ(0) = 0.61; EEF = 0.67, κ(0.5) = 0.32) in this sample. Results provide preliminary support for the use of the PC-PTSD-5 as a brief screening tool for probable PTSD in substance misusing patient populations. Routine use of the PC-PTSD-5 during assessment may be beneficial when treatment planning with those undergoing treatment for SUD because comprehensive assessment and treatment will provide a better chance of long-term recovery.
物质使用障碍(SUD)和创伤后应激障碍(PTSD)共病很常见,与症状严重程度更高、治疗预后更差以及治疗后物质使用复发风险增加有关。尽管具有临床相关性,但 PTSD 的筛查并未在物质使用治疗计划中常规实施。确定可减轻患者负担并允许在此患者人群中进行全面治疗的筛查工具至关重要。本研究在一个以黑人为主要人群的、共 81 名社会经济地位低下的物质滥用住院患者中,检验了用于 DSM-5 的主要医疗 PTSD 筛查工具(PC-PTSD-5)识别 PTSD 的效用。使用建议的 PTSD 检查表 DSM-5 临床截断分(PCL-5)33 分的临床截断分,发现大多数样本(75.3%;n=61)符合 PTSD 可能诊断标准。完成了诊断效用分析,并确定 PC-PTSD-5 的 5 分为最佳表现的截断分数(SE=0.62,κ(1)=0.22;SP=.80,κ(0)=0.61;EEF=0.67,κ(0.5)=0.32)。该结果初步支持在物质滥用患者人群中使用 PC-PTSD-5 作为 PTSD 的简短筛查工具。在接受 SUD 治疗的患者进行评估时,常规使用 PC-PTSD-5 可能有助于治疗计划,因为全面评估和治疗将为长期康复提供更好的机会。