Treatment receipt patterns among individuals with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders.
Treatment receipt patterns among individuals with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders.
复制标题
患有同时发生的创伤后应激障碍（PTSD）和物质使用障碍的个体的治疗接受模式。
DOI：
10.1037/ccp0000600
复制
发表时间：
2020
影响因子：
5.9
通讯作者：
Borowitz,Michelle
中科院分区：
文献类型：
--
作者：
Simpson,TracyL;Hawrilenko,Matt;Goldberg,Simon;Browne,Kendall;Lehavot,Keren;Borowitz,Michelle
目的确定创伤后应激障碍（PTSD）和物质使用障碍（SUD）合并症患者接受治疗的潜在类别，并根据人口统计学、疾病特征和精神病学诊断描述每种类别。方法研究对象为美国酒精及相关疾病流行病学调查iii -终身PTSD和SUD患者（n= 1349，平均年龄40.3，女性62.5%，非白人或西班牙裔白人30.9%）。使用DSM-5酒精使用障碍和相关残疾访谈表收集横断面数据。使用潜在类别分析来识别具有不同治疗接受模式的参与者亚组。结果36%的患者至少接受过1次SUD治疗，84%的患者至少接受过1次心理健康治疗。确定了6个潜在类别：未治疗（17.3%）、门诊MH（34.0%）、门诊+住院MH（17.9%）、SUD（7.3%）、SUD+门诊MH（15.7%）和SUD+门诊MH+住院MH（7.7%）。与非SUD治疗组相比，SUD治疗组表现出更大的社会不稳定性、更高的酒精使用障碍症状严重程度和使用更多的药物类型。接受住院MH治疗的班级有更高的其他合并症和自杀行为发生率。在所有6个类别中，大多数受访者符合慢性创伤后应激障碍的诊断标准（总体：68.9%），而符合慢性SUD诊断标准的较少（总体：38.7%）。结论大多数终生PTSD合并SUD患者均寻求过PTSD或MH治疗，或两者兼有，其中MH治疗的接受率较高。这一共病组有复杂的临床表现，根据治疗亚组的不同而不同，对大多数人来说，尽管接受治疗的比例很高，但他们的PTSD仍然存在。
ObjectiveTo determine latent classes of treatment receipt among people with comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD) and describe each class by demographics, disease characteristics, and psychiatric diagnoses.MethodParticipants were National Epidemiologic Survey on Alcohol and Related Conditions–III respondents with lifetime PTSD and SUD (n= 1,349; mean age 40.3; 62.5% female; 30.9% non-White or Hispanic-White). Cross-sectional data were collected using the DSM–5 Alcohol Use Disorder and Associated Disabilities Interview Schedule. Latent class analysis was used to identify subgroups of participants with different patterns of treatment receipt.ResultsOf the patients, 36% received at least 1 SUD treatment while 84% received at least 1 mental health (MH) treatment. Six latent classes were identified: no treatment (17.3%), outpatient MH (34.0%), outpatient+ inpatient MH (17.9%), SUD (7.3%), SUD+ outpatient MH (15.7%), and SUD+ outpatient MH+ inpatient MH (7.7%). The SUD treatment classes evidenced greater social instability, had higher alcohol use disorder symptom severity, and used more drug types than the non-SUD classes. Classes receiving inpatient MH treatment had a greater incidence of additional comorbid conditions and suicidal behaviors. Across all 6 classes, most respondents met diagnostic criteria for chronic PTSD (overall: 68.9%) while fewer met diagnostic criteria for chronic SUD (overall: 38.7%).ConclusionsMost people with lifetime PTSD and SUD have sought either SUD or MH treatment or both, with substantially greater receipt of MH treatment. This comorbid group has complex clinical presentations that differ depending upon treatment subgroup, and for most, their PTSD persisted despite high rates of treatment engagement.