Posttraumatic Stress Disorder and Substance Use Disorder Screening, Assessment, and Treatment.

IF 5.5 2区医学 Q1 PSYCHIATRY

Current Psychiatry Reports Pub Date : 2024-10-16 DOI:10.1007/s11920-024-01547-8

Samantha C Patton, Laura E Watkins, Therese K Killeen, Denise A Hien

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引用次数: 0

Abstract

Purpose of review: We review prevalence, etiology, impact on treatment, and best practices for treatment of posttraumatic stress disorder (PTSD) in a substance use disorder (SUD) treatment setting. Recommendations are given related to screening, assessment, and symptom monitoring.

Recent findings: PTSD and SUDs are highly comorbid. This comorbidity is associated with higher acuity, more difficulty completing treatment, and worse prognosis. Integrated treatment is recommended, and trauma-focused psychotherapies combined with pharmacotherapy show particular promise. PTSD is highly prevalent in substance using samples, negatively impacting treatment course and worsening prognosis. This comorbidity has been explained by a variety of models, with self-medication having garnered the most support. Trauma-focused psychotherapies combined with pharmacotherapy demonstrate the most efficacy and are recommended when treating co-occurring SUDs and PTSD. Specifically, prolonged exposure (PE), concurrent treatment of PTSD and SUDs using PE (COPE), and cognitive processing therapy (CPT) have been seen as promising trauma-focused treatments. Investigations into ways to best augment therapy are also underway, both through treatment format and neuromodulation. Several recommendations are given.

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创伤后应激障碍和药物使用障碍的筛查、评估和治疗。

综述目的：我们回顾了创伤后应激障碍（PTSD）的患病率、病因、对治疗的影响以及在药物使用障碍（SUD）治疗环境中治疗创伤后应激障碍的最佳实践。本文就筛查、评估和症状监测提出了建议：最近的研究结果：创伤后应激障碍和药物使用障碍高度合并。这种并发症与更高的严重程度、更难完成治疗以及更差的预后有关。建议进行综合治疗，以创伤为重点的心理疗法与药物疗法相结合尤其具有前景。创伤后应激障碍在使用药物的样本中非常普遍，会对治疗过程产生负面影响，并使预后恶化。有多种模式可以解释这种并发症，其中以自我药物治疗获得的支持最多。以创伤为重点的心理疗法与药物疗法相结合的疗效最佳，建议在治疗同时存在的 SUD 和创伤后应激障碍时采用。具体来说，延长暴露疗法（PE）、使用延长暴露疗法同时治疗创伤后应激障碍和药物依赖性失调症（COPE）以及认知处理疗法（CPT）被认为是很有前景的以创伤为重点的治疗方法。通过治疗形式和神经调控，对最佳增强治疗方法的研究也在进行中。本文提出了若干建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Psychiatry Reports PSYCHIATRY-

CiteScore

11.30

自引率

3.00%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal aims to review the most important, recently published research in psychiatry. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by psychiatric disorders. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as anxiety, medicopsychiatric disorders, and schizophrenia and other related psychotic disorders. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.