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Treatment receipt patterns among individuals with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders.
J Consult Clin Psychol. 2020 Nov; 88(11):1039-1051.JC

Abstract

OBJECTIVE

To determine latent classes of treatment receipt among people with comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD) and describe each class by demographics, disease characteristics, and psychiatric diagnoses.

METHOD

Participants were National Epidemiologic Survey on Alcohol and Related Conditions-III respondents with lifetime PTSD and SUD (n = 1,349; mean age 40.3; 62.5% female; 30.9% non-White or Hispanic-White). Cross-sectional data were collected using the DSM-5 Alcohol Use Disorder and Associated Disabilities Interview Schedule. Latent class analysis was used to identify subgroups of participants with different patterns of treatment receipt.

RESULTS

Of the patients, 36% received at least 1 SUD treatment while 84% received at least 1 mental health (MH) treatment. Six latent classes were identified: no treatment (17.3%), outpatient MH (34.0%), outpatient + inpatient MH (17.9%), SUD (7.3%), SUD + outpatient MH (15.7%), and SUD + outpatient MH + inpatient MH (7.7%). The SUD treatment classes evidenced greater social instability, had higher alcohol use disorder symptom severity, and used more drug types than the non-SUD classes. Classes receiving inpatient MH treatment had a greater incidence of additional comorbid conditions and suicidal behaviors. Across all 6 classes, most respondents met diagnostic criteria for chronic PTSD (overall: 68.9%) while fewer met diagnostic criteria for chronic SUD (overall: 38.7%).

CONCLUSIONS

Most people with lifetime PTSD and SUD have sought either SUD or MH treatment or both, with substantially greater receipt of MH treatment. This comorbid group has complex clinical presentations that differ depending upon treatment subgroup, and for most, their PTSD persisted despite high rates of treatment engagement. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Authors+Show Affiliations

Center of Excellence in Substance Addiction, Treatment, and Education (CESATE), VA Puget Sound Health Care.Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine.Department of Counseling, University of Wisconsin-Madison.Center of Excellence in Substance Addiction, Treatment, and Education (CESATE), VA Puget Sound Health Care.Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine.Center of Excellence in Substance Addiction, Treatment, and Education (CESATE), VA Puget Sound Health Care.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32790452

Citation

Simpson, Tracy L., et al. "Treatment Receipt Patterns Among Individuals With Co-occurring Posttraumatic Stress Disorder (PTSD) and Substance Use Disorders." Journal of Consulting and Clinical Psychology, vol. 88, no. 11, 2020, pp. 1039-1051.
Simpson TL, Hawrilenko M, Goldberg S, et al. Treatment receipt patterns among individuals with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders. J Consult Clin Psychol. 2020;88(11):1039-1051.
Simpson, T. L., Hawrilenko, M., Goldberg, S., Browne, K., Lehavot, K., & Borowitz, M. (2020). Treatment receipt patterns among individuals with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders. Journal of Consulting and Clinical Psychology, 88(11), 1039-1051. https://doi.org/10.1037/ccp0000600
Simpson TL, et al. Treatment Receipt Patterns Among Individuals With Co-occurring Posttraumatic Stress Disorder (PTSD) and Substance Use Disorders. J Consult Clin Psychol. 2020;88(11):1039-1051. PubMed PMID: 32790452.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment receipt patterns among individuals with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders. AU - Simpson,Tracy L, AU - Hawrilenko,Matt, AU - Goldberg,Simon, AU - Browne,Kendall, AU - Lehavot,Keren, AU - Borowitz,Michelle, Y1 - 2020/08/13/ PY - 2020/8/14/pubmed PY - 2021/3/2/medline PY - 2020/8/14/entrez SP - 1039 EP - 1051 JF - Journal of consulting and clinical psychology JO - J Consult Clin Psychol VL - 88 IS - 11 N2 - OBJECTIVE: To determine latent classes of treatment receipt among people with comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD) and describe each class by demographics, disease characteristics, and psychiatric diagnoses. METHOD: Participants were National Epidemiologic Survey on Alcohol and Related Conditions-III respondents with lifetime PTSD and SUD (n = 1,349; mean age 40.3; 62.5% female; 30.9% non-White or Hispanic-White). Cross-sectional data were collected using the DSM-5 Alcohol Use Disorder and Associated Disabilities Interview Schedule. Latent class analysis was used to identify subgroups of participants with different patterns of treatment receipt. RESULTS: Of the patients, 36% received at least 1 SUD treatment while 84% received at least 1 mental health (MH) treatment. Six latent classes were identified: no treatment (17.3%), outpatient MH (34.0%), outpatient + inpatient MH (17.9%), SUD (7.3%), SUD + outpatient MH (15.7%), and SUD + outpatient MH + inpatient MH (7.7%). The SUD treatment classes evidenced greater social instability, had higher alcohol use disorder symptom severity, and used more drug types than the non-SUD classes. Classes receiving inpatient MH treatment had a greater incidence of additional comorbid conditions and suicidal behaviors. Across all 6 classes, most respondents met diagnostic criteria for chronic PTSD (overall: 68.9%) while fewer met diagnostic criteria for chronic SUD (overall: 38.7%). CONCLUSIONS: Most people with lifetime PTSD and SUD have sought either SUD or MH treatment or both, with substantially greater receipt of MH treatment. This comorbid group has complex clinical presentations that differ depending upon treatment subgroup, and for most, their PTSD persisted despite high rates of treatment engagement. (PsycInfo Database Record (c) 2020 APA, all rights reserved). SN - 1939-2117 UR - https://www.unboundmedicine.com/medline/citation/32790452/Treatment_receipt_patterns_among_individuals_with_co_occurring_posttraumatic_stress_disorder__PTSD__and_substance_use_disorders_ L2 - http://content.apa.org/journals/ccp/88/11/1039 DB - PRIME DP - Unbound Medicine ER -