Joanna R Sells1, Andrew J Waters2, Melanie L Schwandt3, Laura E Kwako4, Markus Heilig5, David T George6, Vijay A Ramchandani7. 1. Section on Human Psychopharmacology, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA; Laboratory of Cognitive Interventions, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. Electronic address: joanna.sells@nih.gov. 2. Laboratory of Cognitive Interventions, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. Electronic address: andrew.waters@usuhs.edu. 3. Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. Electronic address: melanies@mail.nih.gov. 4. Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. Electronic address: laura.kwako@nih.gov. 5. Center for Social and Affective Neuroscience, Dept. of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden, Sweden. Electronic address: markus.heilig@liu.se. 6. Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. Electronic address: tedg@mail.nih.gov. 7. Section on Human Psychopharmacology, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA. Electronic address: vijayr@mail.nih.gov.
Abstract
BACKGROUND: Post-traumatic stress disorder (PTSD) is often comorbid with alcohol dependence (AD), but little is known about the characteristics of AD treatment-seeking inpatients with PTSD. We examined differences between treatment-seeking alcohol dependent inpatients with and without comorbid PTSD. We hypothesized that those with AD and PTSD would have higher levels of: (1) alcohol use and AD severity; (2) anxiety and mood disorders; (3) neuroticism. METHODS: Individuals (N=411, mean age=41.7±10.0years) with AD were monitored over 30days in a suburban inpatient alcohol treatment setting. Patients were evaluated to identify AD and comorbid PTSD, mood and anxiety disorders, alcohol use and dependence severity, personality, and aggression. RESULTS: Those with PTSD (19% of the sample) did not differ in the amount of alcohol consumed, but had greater: (1) severity of AD (p=0.001, d=0.44); (2) diagnosis of anxiety (p=0.000, OR=3.64) and mood (p=0.000, OR=4.83) disorders; and (3) levels of neuroticism (p<0.001, d=0.67) and aggression (p<0.001, d=0.81). CONCLUSIONS: AD patients with comorbid PTSD present a more severe phenotype across AD severity, frequency of anxiety and mood disorders, and levels of neuroticism and aggression. This group may benefit from concurrent treatment of both AD and PTSD. Future research can investigate neuroticism as a potential treatment target. Published by Elsevier Ireland Ltd.
BACKGROUND: Post-traumatic stress disorder (PTSD) is often comorbid with alcohol dependence (AD), but little is known about the characteristics of AD treatment-seeking inpatients with PTSD. We examined differences between treatment-seeking alcohol dependent inpatients with and without comorbid PTSD. We hypothesized that those with AD and PTSD would have higher levels of: (1) alcohol use and AD severity; (2) anxiety and mood disorders; (3) neuroticism. METHODS: Individuals (N=411, mean age=41.7±10.0years) with AD were monitored over 30days in a suburban inpatient alcohol treatment setting. Patients were evaluated to identify AD and comorbid PTSD, mood and anxiety disorders, alcohol use and dependence severity, personality, and aggression. RESULTS: Those with PTSD (19% of the sample) did not differ in the amount of alcohol consumed, but had greater: (1) severity of AD (p=0.001, d=0.44); (2) diagnosis of anxiety (p=0.000, OR=3.64) and mood (p=0.000, OR=4.83) disorders; and (3) levels of neuroticism (p<0.001, d=0.67) and aggression (p<0.001, d=0.81). CONCLUSIONS:ADpatients with comorbid PTSD present a more severe phenotype across AD severity, frequency of anxiety and mood disorders, and levels of neuroticism and aggression. This group may benefit from concurrent treatment of both AD and PTSD. Future research can investigate neuroticism as a potential treatment target. Published by Elsevier Ireland Ltd.
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