Assessing traumatic experiences in screening for PTSD in substance use disorder patients: What is the gain in addition to PTSD symptoms?

Kok, Tim; Haan, H.; Meer, Margreet van der; Najavits, Lisa M.; Jong, Cor de

doi:10.1016/j.psychres.2015.01.014

Cited by 13 publications

(14 citation statements)

References 53 publications

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“…Interestingly, AI-MD patients showed greater lifetime stressors events such as physical abuse, childhood abuse, intimate partner violence, etc. These findings are consistent with other animal and human studies reporting an association between traumatic events and SUDs [ 63 , 64 , 65 , 66 , 67 ]. Furthermore, as expected, AI-MD showed more medical comorbidity possibly by the effects related to the alcohol use, and its toxicity [ 68 ].…”

Section: Discussionsupporting

confidence: 93%

Alcohol Induced Depression: Clinical, Biological and Genetic Features

Farré

Tirado

Spataro

et al. 2020

JCM

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Background: In clinical practice, there is the need to have clinical and biological markers to identify induced depression. The objective was to investigate clinical, biological and genetic differences between Primary Major Depression (Primary MD) and Alcohol Induced MD (AI-MD). Methods: Patients, of both genders, were recruited from psychiatric hospitalisation units. The PRISM instrument was used to establish the diagnoses. Data on socio-demographic/family history, clinical scales for depression, anxiety, personality and stressful life events were recorded. A blood test was performed analysing biochemical parameters and a Genome Wide Association Study (GWAS) to identify genetic markers associated with AI-MD. Results: A total of 80 patients were included (47 Primary MD and 33 AI-MD). The AI-MD group presented more medical comorbidities and less family history of depression. There were differences in traumatic life events, with higher scores in the AI-MD (14.21 ± 11.35 vs. 9.30 ± 7.38; p = 0.021). DSM-5 criteria were different between groups with higher prevalence of weight changes and less anhedonia, difficulties in concentration and suicidal thoughts in the AI-MD. None of the genetic variants reached significance beyond multiple testing thresholds; however, some suggestive variants were observed. Conclusions: This study has found clinical and biological features that may help physicians to identify AI-MD and improve its therapeutic approach.

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Section: Discussionsupporting

confidence: 93%

Alcohol Induced Depression: Clinical, Biological and Genetic Features

Farré

Tirado

Spataro

et al. 2020

JCM

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“…Our finding that TEs alone are not associated with higher SUD severity is supported by research examining the relationship between PTSD and SUD in adolescents and adults (35)(36). Reed et al (37) found that in adolescents, the presence of PTSD but not TEs without PTSD is associated with a higher risk for future substance abuse or dependence.…”

Section: Discussionsupporting

confidence: 74%

Traumatic Events and Substance Use Disorders in Adolescents

et al. 2020

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Objectives: Adolescents with substance use disorders (SUD) frequently report traumatic events (TEs) and symptoms of post-traumatic stress disorder (PTSD). This study aimed to assess whether lifetime prevalence rates of TEs and PTSD are related to SUD severity in adolescent psychiatric patients. Methods:We analyzed N = 114 self-reports of treatment-seeking German adolescents aged 12 to 18 years, who visited a specialized SUD outpatient unit. Standardized questionnaires were applied to assess SUD severity, the number of TEs and DSM-IV PTSD criteria.Results: Patients fulfilling PTSD criteria (28% of the total sample) had a higher Drug Use Disorders Identification Test (DUDIT) score compared to non-PTSD patients with TEs (p <.001), and compared to adolescents without TEs or PTSD (p = .003). Additionally, SUD severity was positively associated with the number of TEs and the number of intrusion, hyperarousal, and avoidance symptoms (all r = .33 to.48, all p <.01).Discussion: Adolescent patients with SUD reported 3-times higher rates of TEs, and a 5time higher prevalence of PTSD following TEs, than the general adolescent population. Adolescent SUD patients with PTSD reported more severe substance use problems than patients without PTSD-regardless of previous TEs. Longitudinal studies are needed in order to investigate the temporal relationship between TEs, PTSD and SUD.

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“…Finally, the “susceptibility model” posits high anxiety and arousal as a consequence of chronic substance use, which in turn leads to a higher risk of PTSD [ 15 ]. Besides the lack of consensus between the different explanatory models, there does seem to be an agreement that SUD increases the severity of PTSD presentation, and PTSD seems to be an independent risk factor for an unfavorable outcome of SUD [ 4 , 16 , 17 ]. Specifically, patients with both disorders present a worse prognosis and evolution [ 4 ], a greater number of further comorbid somatic and psychiatric disorders [ 18 ], a higher number of detoxification treatment admissions and relapses [ 19 ], an earlier start to substance use [ 20 ], greater number of years of use [ 21 ], a poly-substance consumption pattern [ 22 ], a greater severity of PTSD symptoms [ 23 ], and a higher number, as well as a greater severity and intensity, of dissociative symptoms in those with poly-substance SUD [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

“…Each item is scored on a 3-or 5-point scale, depending on the item, with a maximum score of 52. Scores are interpreted as follows: no depression (0-7), mild depression (8)(9)(10)(11)(12)(13)(14)(15)(16), moderate depression (17)(18)(19)(20)(21)(22)(23), and severe depression (≥ 24). 4.…”

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confidence: 99%

Traumatic Events in Dual Disorders: Prevalence and Clinical Characteristics

Blanco

Sió²,

Hogg

et al. 2020

JCM

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Psychological trauma has been identified in substance use disorders (SUD) as a major etiological risk factor. However, detailed and systematic data about the prevalence and types of psychological trauma in dual disorders have been scarce to date. In this study, 150 inpatients were recruited and cross-sectionally screened on their substance use severity, psychological trauma symptoms, comorbidities, and clinical severity. One hundred patients fulfilled criteria for a dual disorder, while 50 patients were diagnosed with only SUD. Ninety-four percent of the whole sample suffered from at least one lifetime traumatic event. The prevalence rates of Posttraumatic Stress Disorder diagnosis for dual disorder and only SUD was around 20% in both groups; however, patients with dual disorder presented more adverse events, more childhood trauma, more dissociative symptoms, and a more severe clinical profile than patients with only SUD. Childhood maltreatment can also serve as a predictor for developing a dual disorder diagnosis and as a risk factor for developing a more complex and severe clinical profile. These data challenge our current clinical practice in the treatment of patients suffering from dual disorder or only SUD diagnosis and favor the incorporation of an additional trauma-focused therapy in this population. This may improve the prognosis and the course of the illness in these patients.

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Assessing traumatic experiences in screening for PTSD in substance use disorder patients: What is the gain in addition to PTSD symptoms?

Cited by 13 publications

References 53 publications

Alcohol Induced Depression: Clinical, Biological and Genetic Features

Alcohol Induced Depression: Clinical, Biological and Genetic Features

Traumatic Events and Substance Use Disorders in Adolescents

Traumatic Events in Dual Disorders: Prevalence and Clinical Characteristics

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