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描述和比较共病 PTSD 和物质使用障碍的退伍军人中基于证据的心理治疗利用情况。

Characterizing and Comparing Evidence-Based Psychotherapy Utilization Among Veterans with Co-occurring PTSD and Substance Use Disorder.

机构信息

Center to Improve Veteran Involvement in Care, VA Portland Healthcare System, Portland, Oregon, USA.

School of Medicine, Oregon Health and Science University, Portland, Oregon, USA.

出版信息

Subst Use Misuse. 2024;59(3):425-431. doi: 10.1080/10826084.2023.2275566. Epub 2024 Jan 25.

Abstract

: The current study sought to describe a nationally representative sample of Veterans diagnosed with co-occurring PTSD and substance use disorder (SUD) who initiated and completed evidence-based psychotherapy (EBP) for PTSD, and explored whether completion rates differed by SUD subtype. : Using electronic health record data from the Veterans Health Administration (VHA) Corporate Data Warehouse, Veterans with a dual diagnosis of PTSD and SUD who initiated either Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE) between January 01, 2019 and July 16, 2019 were identified ( = 2,996). Logistic analyses were employed to determine whether there were differences in EBP completion rates among Veterans with an alcohol use disorder (AUD;  = 1,383) versus all other SUDs  = 1,613). : On average, Veterans were 45 years old, and identified as male, White, and non-Hispanic. Logistic regression analyses revealed there was not a significant difference between Veterans with AUD only and other SUDs in the probability of completing EBP treatment,  = 1.02, 95% CI =0.87, 1.17,  = 0.79. No differences in EBP completion rates were observed between SUD subtypes, indicating that EBPs for PTSD are tolerated well for individuals with various types of SUDs and may be offered as treatment options.

摘要

: 本研究旨在描述一个全国代表性的样本,这些退伍军人同时被诊断患有创伤后应激障碍(PTSD)和物质使用障碍(SUD),他们开始并完成了针对 PTSD 的循证心理治疗(EBP),并探讨了 SUD 亚型是否会影响完成率。: 使用退伍军人事务部(VA)公司数据仓库的电子健康记录数据,确定了在 2019 年 1 月 1 日至 2019 年 7 月 16 日期间开始接受认知加工治疗(CPT)或延长暴露治疗(PE)的 PTSD 和 SUD 双重诊断的退伍军人( = 2996)。采用逻辑回归分析来确定是否存在酒精使用障碍(AUD; = 1383)与所有其他 SUD( = 1613)退伍军人的 EBP 完成率差异。: 平均而言,退伍军人年龄为 45 岁,男性,白人,非西班牙裔。逻辑回归分析显示,仅有 AUD 的退伍军人和其他 SUD 退伍军人在完成 EBP 治疗的概率方面没有显著差异, = 1.02,95%CI=0.87,1.17, = 0.79。在 EBP 完成率方面没有观察到 SUD 亚型之间的差异,这表明 PTSD 的 EBP 对于各种类型的 SUD 个体都能很好地耐受,可以作为治疗选择。

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