Posttraumatic stress disorder among substance users from the general population.
Posttraumatic stress disorder among substance users from the general population.
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DOI：
10.1176/ajp.149.5.664
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发表时间：
1992-05
期刊：
影响因子：
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通讯作者：
L. Cottler;W. Compton;D. Mager;E. Spitznagel;A. Janča
中科院分区：
文献类型：
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作者：
L. Cottler;W. Compton;D. Mager;E. Spitznagel;A. Janča
目的了解一般人群中物质使用者创伤后应激障碍（PTSD）的患病率。方法圣路易斯流行病学集水区研究，在一般人群中的精神疾病的调查，收集数据的PTSD和物质使用的诊断访谈时间表。在2,663名受访者中，430人报告了可能符合PTSD的创伤事件;然而，PTSD的发生率很低，总体为1.35%。为了评估创伤后应激障碍和物质使用之间的关系，受访者被分层分为四个物质使用类别之一，从多种药物使用到酒精使用。将每个类别的物质使用者以及一般物质使用者与不符合物质使用阈值的人（比较对象）进行比较。结果研究结果表明，可卡因/阿片类药物使用者报告创伤性事件的可能性是比较受试者的三倍以上，报告更多的症状和事件，并且更有可能符合PTSD的诊断标准。身体攻击，而不是与战斗有关的事件，是可卡因/阿片剂使用者中报告的最普遍的事件。物质使用的发病先于创伤后症状的发病，这表明物质使用倾向于个人暴露于创伤性事件。当其他变量（包括反社会行为）被控制时，女性性别和可卡因/阿片类药物的使用可以预测PTSD。结论：这些对物质滥用和PTSD共同发生的分析值得进一步研究，并表明PTSD在物质滥用者中比以前所知的更为常见。
OBJECTIVE The purpose of the study was to evaluate the prevalence of posttraumatic stress disorder (PTSD) among substance users in the general population. METHOD The St. Louis Epidemiologic Catchment Area study, a survey of psychiatric illness in the general population, collected data on PTSD and substance use with the Diagnostic Interview Schedule. Among the 2,663 respondents, 430 reported a traumatic event that could qualify for PTSD; however, the rate of PTSD was low, 1.35% overall. To evaluate the relationship between PTSD and substance use, respondents were hierarchically classified into one of four substance use categories ranging from polydrug use to alcohol use only. Substance users from each category as well as substance users in general were compared with persons who did not meet the substance use threshold (comparison subjects). RESULTS Findings indicate that cocaine/opiate users are over three times as likely as comparison subjects to report a traumatic event, report more symptoms and events, and are more likely to meet diagnostic criteria for PTSD. Physical attack, but not combat-related events, was the most prevalent event reported among cocaine/opiate users. Onset of substance use preceded onset of posttraumatic symptoms, suggesting that substance use predisposes the individual to exposure to traumatic events. When other variables--including antisocial behavior--were controlled, female gender and use of cocaine/opiates predicted PTSD. CONCLUSIONS These analyses of the co-occurrence of substance abuse and PTSD warrant further study and suggest that PTSD is much more common among substance abusers than was previously known.