Monotonic Association of Increasing Past-Year Substance Use Disorder across a Four-Level Trauma Post-Traumatic Stress Disorder (PTSD) Hierarchy in a Nationwide Sample.

IF 1.5 4区医学 Q3 PSYCHIATRY

Journal of Dual Diagnosis Pub Date : 2023-10-01 Epub Date: 2023-11-01 DOI:10.1080/15504263.2023.2260339

Oluwole Jegede, Ajay Manhapra, Bin Zhou, Taeho Greg Rhee, Robert A Rosenheck

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引用次数: 1

Abstract

Objective: There is limited information on the differences in the association of substance use disorders (SUD) with four clinically relevant hierarchical groups based on trauma exposure and its consequences (1-no trauma; 2-trauma but no PTSD; 3-remitted PTSD; and 4-current PTSD).

Methods: Among adults enrolled in a large nationally representative survey, the National Epidemiologic Survey on Alcohol and Related Conditions Wave III (NESARC III), we compared differences in SUD prevalence between each of the hierarchical trauma group and the prior group adjusting for potentially confounding factors.

Results: Unadjusted results show that each increase in the hierarchy was associated with a greater likelihood of SUD diagnoses, even after adjusting for potentially confounding variables. However, after adjusting for covariates, comparison of adults with past to those with current PTSD showed persistence of SUD indicators.

Conclusion: SUD prevalence increased substantially with trauma exposure even without PTSD and monotonically increased further with past and current PTSD, respectively, illustrating the differential effect of the clinical consequences of trauma.

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全国样本中四级创伤后应激障碍（PTSD）等级中过去一年药物使用障碍增加的单调关联。

目的：关于物质使用障碍（SUD）与基于创伤暴露及其后果的四个临床相关等级组（1-无创伤；2-创伤但无创伤后应激障碍；3-缓解后应激障碍和4-现患后应激障碍）的关联差异的信息有限。方法：在参加一项具有全国代表性的大型调查——全国酒精及相关疾病流行病学调查第三波（NESARC III）的成年人中，我们比较了分级创伤组和先前组之间SUD患病率的差异，并对潜在的混杂因素进行了调整。结果：未经调整的结果表明，即使在调整了潜在的混杂变量后，层次结构的每一次增加都与SUD诊断的可能性更大有关。然而，在对协变量进行调整后，将过去患有创伤后应激障碍的成年人与现在患有创伤后抑郁障碍的成年人进行比较，结果显示SUD指标持续存在。结论：即使没有创伤后应激障碍，SUD的患病率也随着创伤暴露的增加而显著增加，并且随着过去和现在的创伤后应激应激障碍而进一步单调增加，这说明了创伤的临床后果的不同影响。

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

Journal of Dual Diagnosis Multiple-

CiteScore

4.90

自引率

13.60%

发文量

期刊介绍： Journal of Dual Diagnosis is a quarterly, international publication that focuses on the full spectrum of complexities regarding dual diagnosis. The co-occurrence of mental health and substance use disorders, or “dual diagnosis,” is one of the quintessential issues in behavioral health. Why do such high rates of co-occurrence exist? What does it tell us about risk profiles? How do these linked disorders affect people, their families, and the communities in which they live? What are the natural paths to recovery? What specific treatments are most helpful and how can new ones be developed? How can we enhance the implementation of evidence-based practices at clinical, administrative, and policy levels? How can we help clients to learn active recovery skills and adopt needed supports, clinicians to master new interventions, programs to implement effective services, and communities to foster healthy adjustment? The Journal addresses each of these perplexing challenges.