Clinical challenges in the treatment of patients with posttraumatic stress disorder and substance abuse.
OBJECTIVE
The aim of this article is to review the current literature on co-occuring posttraumatic stress disorder and substance-use disorder, with an emphasis on clinical aspects and emerging treatments.


RESULTS
In clinical populations (focusing on either disorder), about 25-50% have a lifetime dual diagnosis of posttraumatic stress disorder and substance-use disorder. Patients with both disorders have a more severe clinical profile than those with either disorder alone, lower functioning, poorer well being, and worse outcomes across a variety of measures. In recent years, several promising treatment programs have been developed specifically for co-occuring posttraumatic stress disorder and substance-use disorder, with one model having been established as effective thus far.


CONCLUSIONS
Comorbid posttraumatic stress disorder/substance-use disorder is a frequent diagnosis in clinical populations that severely affects course and outcome. Treatment approaches appropriate for this vulnerable population need to be evaluated further and implemented in routine practice.
Schäfer
Ingo
I
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. i.schaefer@uke.uni-hamburg.de
Najavits
Lisa M
LM
D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D006801:Humans; D011613:Psychotherapy / Q000379:methods; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D019966:Substance-Related Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome