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A systematic review of the comorbidity between PTSD and alcohol misuse

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Abstract

Purpose

This systematic review aimed to assess (1) the level of comorbidity of post-traumatic stress disorder (PTSD) and alcohol misuse reported in research studies since 2007 and (2) any associations found between specific PTSD symptom clusters and alcohol misuse.

Methods

A literature search was carried out to capture any papers published from 2007 to the end of July 2012. Six hundred and twenty abstracts were identified and reviewed, and 42 papers were included in the final review after applying inclusion and exclusion criteria.

Results

The prevalence of comorbid alcohol misuse in those with PTSD ranged from 9.8 to 61.3 %. The prevalence of comorbid PTSD in those with alcohol misuse ranged from 2.0 to 63.0 %, and the majority of prevalence rates were over 10.0 %. Almost all of the odds ratios representing the strength of association between the conditions across a variety of populations were significant, and those ranged from 1.1 to 4.87. Of the different PTSD symptom clusters, this review found most evidence for associations between alcohol misuse and both avoidance/numbing symptoms and hyperarousal symptoms.

Conclusions

Given that comorbidity appears to be common, the evidence from this systematic review supports the use of routine screening for comorbidity in populations who are known to have PTSD or alcohol misuse.

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Acknowledgments

This research received no specific grant from any funding agency, commercial or not-for-profit sectors. Dr Laura Goodwin receives salary support from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London.

Conflict of interest

Professor Simon Wessely is Honorary Civilian Consultant Advisor in Psychiatry to the British Army and a Trustee of Combat Stress, a UK charity that provides services and support for veterans with mental health problems.

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Authors and Affiliations

  1. King’s College London School of Medicine, Hodgkin Building, Guy’s Campus, London, SE1 1UL, UK

    Frances Debell & Marc Head

  2. King’s Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychiatry, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ, UK

    Nicola T. Fear, Samantha Batt-Rawden, Simon Wessely & Laura Goodwin

  3. Academic Centre for Defence Mental Health, Department of Psychological Medicine, Institute of Psychiatry, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ, UK

    Nicola T. Fear & Neil Greenberg

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  1. Frances Debell
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  2. Nicola T. Fear
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  6. Simon Wessely
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Correspondence to Laura Goodwin.

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Debell, F., Fear, N.T., Head, M. et al. A systematic review of the comorbidity between PTSD and alcohol misuse. Soc Psychiatry Psychiatr Epidemiol 49, 1401–1425 (2014). https://doi.org/10.1007/s00127-014-0855-7

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  • DOI: https://doi.org/10.1007/s00127-014-0855-7

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