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Clinical presentations, social functioning, and treatment receipt among individuals with comorbid life‐time PTSD and alcohol use disorders versus drug use disorders: findings from NESARC‐III
Author(s) -
Simpson Tracy L.,
Rise Peter,
Browne Kendall C.,
Lehavot Keren,
Kaysen Debra
Publication year - 2019
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.14565
Subject(s) - psychiatry , comorbidity , social functioning , receipt , alcohol use disorder , clinical psychology , medicine , addiction , psychology , drug , alcohol , biochemistry , chemistry , distress , world wide web , computer science
Aims 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. Design and Setting Cross‐sectional cohort study using data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC‐III). Participants 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%. Measurements 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. Findings 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. Conclusions 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.