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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.

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Title: 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.
Authors: Simpson, Tracy L. (AUTHOR), Rise, Peter (AUTHOR), Browne, Kendall C. (AUTHOR), Lehavot, Keren (AUTHOR), Kaysen, Debra (AUTHOR)
Source: Addiction. Jun2019, Vol. 114 Issue 6, p983-993. 11p. 5 Charts.
Subjects: Treatment of post-traumatic stress disorder, Alcohol-induced disorders, Comorbidity, Substance-induced disorders, Social skills, Epidemiological research, Diagnosis of alcoholism, Mental illness treatment, Diagnosis of post-traumatic stress disorder, Substance abuse treatment, Substance abuse diagnosis, Comparative studies, Interviewing, Longitudinal method, Mental illness, Classification of mental disorders, Surveys, Sample size (Statistics), Multiple regression analysis, Statistical reliability, Disease prevalence, Cross-sectional method, Odds ratio
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. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: 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.
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– Name: Abstract
  Label: Abstract
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  Data: 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. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/add.14565
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      – SubjectFull: Treatment of post-traumatic stress disorder
        Type: general
      – SubjectFull: Alcohol-induced disorders
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      – SubjectFull: Diagnosis of alcoholism
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      – SubjectFull: Substance abuse treatment
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      – TitleFull: 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.
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