Comorbidity of posttraumatic stress disorder with alcohol dependence among US adults: Results from National Epidemiological Survey on Alcohol and Related Conditions

Abstract

Background Despite the high rates of comorbidity of post-traumatic stress disorder (PTSD) and alcohol dependence (AD) in clinical and epidemiological samples, little is known about the prevalence, clinical presentation, course, risk factors and patterns of treatment-seeking of co-occurring PTSD-AD among the general population. Methods The sample included respondents of the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Weighted means, frequencies and odds ratios (ORs) of sociodemographic correlates, prevalence of psychiatric disorders and rates of treatment-seeking were computed. Results: In the general population, the lifetime prevalence of PTSD only, AD only and PTSD-AD was 4.83%, 13.66% and 1.59%, respectively. Individuals with comorbid PTSD-AD were more likely than those with PTSD or AD only to have suffered childhood adversities and had higher rates of Axis I and II disorders and suicide attempts. They also met more PTSD diagnostic criteria, had earlier onset of PTSD and were more likely to use drugs and alcohol to relieve their PTSD symptoms than those with PTSD only; they also met more AD diagnostic criteria than those with AD only and had greater disability. Individuals with PTSD-AD had higher rates of treatment seeking for AD than those with AD only, but similar rates than those with PTSD only. Conclusion PTSD-AD is associated with high levels of severity across a broad range of domains even compared with individuals with PTSD or AD only, yet treatment-seeking rates are very low. There is a need to improve treatment access and outcomes for individuals with PTSD-AD.

Early Screening for Posttraumatic Stress Disorder in Inpatient Detoxification and Motivation Treatment: Results and Consequences

“…Childhood adversities, particularly sexual abuse below the age of 16, but also having been raised in a foster home have recently been identified as specific contributors for the co-occurrence of PTSD and alcohol use disorders in a Swiss community sample [39]. Since childhood adversities and particularly childhood abuse are risk factors for both, the development of PTSD [40] and SUDs, our data add to the evidence linking childhood adversities and abuse to substance use and PTSD [2,15,39].…”

“…Patients with SUDs and comorbid PTSD are clinically more severely affected, have higher rates of other comorbid mental disorders, more medical, psychosocial and interpersonal problems and worse treatment-outcomes [1][2][3][4]. Prior to the present study, an evaluation of trauma/PTSD in Swiss SUD inpatients has not been performed.…”

The prevalence and risk of metabolic syndrome and its components among people with posttraumatic stress disorder: a systematic review and meta-analysis

“…Fourth, it might be that a cumulative long-term effect of poor health behaviors places people with PTSD at the greatest risk for cardiometabolic disorders, more so than the psychiatric diagnosis per se. People with PTSD are more likely than the general population to have unhealthy lifestyle behaviors, such as being sedentary [51], smoking [52], alcohol and substance abuse [53], and having diets that are high in saturated fats and refined sugars [54], while low in fruit [55], placing them at higher risk for MetS and CVD than the general population. Future research should comprehensively assess MetS risk factors and evaluate lifestyle interventions.…”

Posttraumatic stress avoidance symptoms as mediators in the development of alcohol use disorders after exposure to childhood sexual abuse in a Swiss community sample

“…This often includes the development of symptoms, such as autonomic hyperarousal, avoidant behaviors, and reexperiencing phenomena, which constitute the core diagnostic criteria for posttraumatic stress disorder (PTSD) according to the DSM-IV (APA, 1994). Therefore, it is not surprising that the comorbidity of AUD with PTSD (Leeies, Pagura, Sareen, & Bolton, 2010) is comparably higher for childhood or adult sexual trauma than for any other types of trauma (Blanco, et al, 2013;Najavits, Weiss, & Shaw, 1997).…”