title: Posttraumatic stress disorder, gender, and problem profiles in substance dependent patients.
abstract: Patients with a chronic and severe substance-use disorder who also have a history of posttraumatic stress disorder (PTSD) are thought to have a unique set of problems. The present study assessed psychiatric disorders, psychosocial problems, and traumatic events with structured interviews in 747 men and 693 women enrolling in urban opioid substitution treatment programs from 1995 to 2001. Participants with versus without a history of PTSD were more likely to have a history of many other psychiatric disorders and demonstrated more current and historical medical, employment, family/social, and psychiatric problems. PTSD was generally unrelated to substance-use disorder severity or diagnoses, with the exception of an increased risk of alcohol dependence. Women were more likely than men to have experienced sexual assault, and less likely to have been physically assaulted, although these events precipitated PTSD at equivalent rates across gender. In contrast, witnessing or hearing about the death or injury of others was more likely to precipitate PTSD in women than men. Female gender, exposure to combat, sexual assault, or physical assault, and a history of major mood or anxiety disorder were the best predictors of PTSD in this group. Study limitations are noted.
authors.affiliation: Addiction Treatment Services, Johns Hopkins Bayview Medical Center, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA. jmpeirce@jhmi.edu
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Peirce
authors.forename: Kori A
authors.initials: KA
authors.lastname: Kindbom
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Waesche
authors.forename: Abigail S E
authors.initials: AS
authors.lastname: Yuscavage
authors.forename: Robert K
authors.initials: RK
authors.lastname: Brooner
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D002908:Chronic Disease; D003130:Combat Disorders / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011336:Probability; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data; D012917:Social Adjustment; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data