Integrating treatment for alcohol use problems and comorbid PTSD

共病性酒精使用问题和创伤后应激障碍（PTSD）是常见的精神健康问题，会导致残疾和痛苦。尽管如此，很少有干预的随机对照试验。拟议的研究是澳大利亚在该领域的第一个随机对照试验，以解决治疗创伤后应激障碍和酒精使用问题是否优于单独治疗酒精使用问题的问题。该研究比较了手工指导治疗酒精使用障碍与同时治疗酒精使用和创伤后应激障碍的相对疗效。本研究改进了在已发表文献中报道的两项现有研究中所描述的方法学局限性。264名参与者将从多个地点（媒体、全科医生、专科诊所）招募，并在悉尼的两个地点进行社区治疗。如果参与者摄入有害水平的酒精（NHMRC风险或高风险水平），并且根据公认的诊断标准同时诊断为创伤后应激障碍，则他们将符合条件。治疗将包括16次手工指导的个人心理治疗，已被发现对每个问题都非常有效。治疗效果将根据有害饮酒（高于NHMRC低风险水平）的减少和创伤后应激障碍症状的减少来确定。参与者将在治疗完成后3个月和6个月由一位独立的、盲的临床医生进行随访。这项研究的结果有可能为临床医生和政策制定者提供有关这些复杂症状患者治疗需求的宝贵信息。

Comorbid alcohol use problems and posttraumatic stress disorder (PTSD) are common mental health problems that cause disability and distress. Despite this, there are few randomized controlled trials of interventions. The proposed study is the first Australian randomised controlled trial in this field to address the question of whether treating PTSD and alcohol use problems is superior to treating alcohol use problems alone. The study compares the relative efficacy of a manual guided treatment for alcohol use disorder alone with a simultaneous treatment for alcohol use and PTSD. This study improves on the methodological limitations described in the two existing studies reported in the published literature. Two-hundred and sixty four participants will be recruited from mutiple sites (media, GPs, specialist clinics) and treated in the community at two sites in Sydney. Participants will be eligible if they consume harmful levels of alcohol (NHMRC risky or high risk levels) and have a concurrent diagnosis of PTSD based on recognised diagnostic criteria. Treatment will consist of 16 sessions of manual guided individual psychological therapy that has been found to be very efficacious with each problem alone. The efficacy of treatment will be determined on the basis of reductions in harmful drinking (above NHMRC low risk levels) and in symptoms of PTSD. Participants will be followed up by an independent, blind, clinician three and six months after treatment completion. The findings of this study have the potential to provide valuable information regarding the treatment needs of people with these complex presentations to clinicians and policy developers alike.