Article

Symptom improvement in co-occurring PTSD and alcohol dependence.

Medical University of South Carolina, Department of Psychiatry, Charleston, South Carolina 29425, USA.
Journal of Nervous & Mental Disease (Impact Factor: 1.81). 10/2006; 194(9):690-6. DOI: 10.1097/01.nmd.0000235794.12794.8a
Source: PubMed

ABSTRACT This study investigated the temporal course of improvement in PTSD and alcohol dependence symptoms among individuals participating in a 12-week outpatient treatment study. Participants were 94 individuals with comorbid PTSD and alcohol dependence enrolled in a double-blind, placebo-controlled medication trial. Outcome measures included PTSD symptoms (as measured by the Clinician Administered PTSD Scale, Impact of Events Scale, and Civilian Mississippi Scale for PTSD) and alcohol use severity (as measured by the Time Line Follow Back). Study completion rates were significantly higher for individuals who demonstrated improvement in both disorders. Improvements in PTSD had a greater impact on improvement in alcohol dependence symptoms than the reciprocal relationship. Improvement in hyperarousal PTSD symptoms, in particular, was related to substantially improved alcohol use. Examination of the temporal course of symptom improvement revealed that alcohol symptoms tended to start improving either before or in conjunction with PTSD symptoms. Although preliminary in nature, these findings suggest that co-occurring PTSD symptoms may have a strong impact on alcohol dependence treatment outcome, and that PTSD treatment may be important to optimizing outcomes for patients with comorbid PTSD and alcohol dependence.

3 Followers
 · 
80 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Comorbidity of substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) among combat Veterans is common, which creates a need for special consideration of treatment options. Controversy regarding trauma-focused treatments for individuals with comorbid SUDs may cause barriers to treatment delivery. Cognitive processing therapy (CPT) is frequently recommended for treatment of PTSD, but little is known about whether substance use comorbidity affects the outcome. This study compared outcomes for Veterans with PTSD and a substance misuse pattern against Veterans with PTSD without a comorbid SUD, who participated in a six-week residential group CPT treatment program. Lack of significant differences between groups on outcomes for PTSD or depression, p > 0.05, suggests that individuals with comorbid substance misuse have outcomes for PTSD and depression similar to those without substance use comorbidity. Trauma-focused treatments may not be as problematic in this population as many clinicians believe. Attrition and demographic differences between the groups were also explored.
    Addiction Research and Theory 08/2013; 21(5). DOI:10.3109/16066359.2012.746316 · 1.03 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The co-occurrence of substance use disorders with anxiety disorders and/or posttraumatic stress disorder has been widely documented and when compared to each disorder alone, consistently linked to increased risk for a host of negative outcomes including greater impairment, poorer treatment response, and higher rates of symptom relapse. This article focuses on recent advances in the understanding and effective treatment of this common and highly complex comorbidity. Prevalence and epidemiological data are introduced, followed by a review of contemporary models of etiology and associative pathways. Conceptualizations of effective treatment approaches are discussed alongside evidence from the past decade of clinical research trials. Highlighted are ongoing questions regarding the benefit of sequential, parallel, and integrated approaches and the necessity of further investigation into the mechanisms underlying treatment efficacy. Lastly, recent contributions from neuroscience research are offered as a promising bridge for the development and testing of novel, interdisciplinary treatment approaches.
    Current Psychiatry Reports 11/2014; 16(11):505. DOI:10.1007/s11920-014-0505-5 · 3.05 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: AimsThis study aimed to test the efficacy of integrated cognitive behaviour therapy (CBT) for coexisting post‐traumatic stress disorder (PTSD) and alcohol use disorders (AUD). SettingClinics across Sydney, Australia. DesignRandomized controlled trial of 12 once‐weekly individual sessions of either integrated CBT for PTSD and AUD (integrated therapy, IT; n = 33) or CBT for AUD plus supportive counselling (alcohol‐support, AS; n = 29). Blind assessments were conducted at baseline and post‐treatment and at 5 [standard deviation (SD) = 2.25] and 9.16 (SD = 3.45) months post‐treatment. ParticipantsSixty‐two adults with concurrent PTSD and AUD. MeasurementsOutcomes included changes in alcohol consumption (time‐line follow‐back), PTSD severity [clinician‐administered PTSD scale (CAPS)], alcohol dependence and problems, and depression and anxiety. FindingsReductions in PTSD severity were evident in both groups. IT participants who had received one or more sessions of exposure therapy exhibited a twofold greater rate of clinically significant change in CAPS severity at follow‐up than AS participants [IT 60%, AS 39%, odds ratio (OR): 2.31, 95% confidence interval (CI): 1.06, 5.01]. AS participants exhibited larger reductions than IT participants in alcohol consumption, dependence and problems within the context of greater treatment from other services during follow‐up. Results lend support to a mutually maintaining effect between AUD and PTSD. Conclusions Individuals with severe and complex presentations of coexisting post‐traumatic stress disorder (PTSD) and alcohol use disorders (AUD) can derive substantial benefit from cognitive behaviour therapy targeting AUD, with greater benefits associated with exposure for PTSD. Among individuals with dual disorders, these therapies can generate significant, well‐maintained treatment effects on PTSD, AUD and psychopathology.
    Addiction 08/2013; 108(8). DOI:10.1111/add.12167 · 4.60 Impact Factor

Full-text (2 Sources)

Download
265 Downloads
Available from
Jun 3, 2014