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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.
Addiction. 2019 06; 114(6):983-993.A

Abstract

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.

Authors+Show Affiliations

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.Denver-Seattle Center of Innovation for Veteran-Centered Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA.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. Center of Excellence in Substance Abuse and Treatment (CESATE), Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. Denver-Seattle Center of Innovation for Veteran-Centered Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA. Department of Health Services, University of Washington, Seattle, WA, USA.Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

30694592

Citation

Simpson, Tracy L., et al. "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." Addiction (Abingdon, England), vol. 114, no. 6, 2019, pp. 983-993.
Simpson TL, Rise P, Browne KC, et al. 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. Addiction. 2019;114(6):983-993.
Simpson, T. L., Rise, P., Browne, K. C., Lehavot, K., & Kaysen, D. (2019). 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. Addiction (Abingdon, England), 114(6), 983-993. https://doi.org/10.1111/add.14565
Simpson TL, et al. 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. Addiction. 2019;114(6):983-993. PubMed PMID: 30694592.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Simpson,Tracy L, AU - Rise,Peter, AU - Browne,Kendall C, AU - Lehavot,Keren, AU - Kaysen,Debra, Y1 - 2019/03/10/ PY - 2018/09/11/received PY - 2018/11/18/revised PY - 2019/01/23/accepted PY - 2019/1/30/pubmed PY - 2020/7/17/medline PY - 2019/1/30/entrez KW - Alcohol use disorders KW - comorbidity KW - cross-sectional Cohort Study KW - drug use disorders KW - epidemiology KW - post-traumatic stress disorder SP - 983 EP - 993 JF - Addiction (Abingdon, England) JO - Addiction VL - 114 IS - 6 N2 - 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. SN - 1360-0443 UR - https://www.unboundmedicine.com/medline/citation/30694592/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_ DB - PRIME DP - Unbound Medicine ER -