title: Childhood trauma and dissociation in patients with alcohol dependence, drug dependence, or both-A multi-center study.
abstract: BACKGROUND
  The aims of this study were to examine the level of dissociative symptoms in patients with different substance related disorders (alcohol dependence, drug dependence, and combined alcohol and drug dependence), and to investigate the influence of potentially traumatic events in childhood, age, gender, and posttraumatic stress disorder on the relationship between dissociative symptoms and type of substance abuse.
  
  
  METHODS
  Of the 459 participants (59.7% male) 182 (39.7%) were alcohol-dependent (A), 154 (33.6%) were drug-dependent (D), and 123 (26.8%) were dependent on both, alcohol and drugs (AD) based on the DSM-IV criteria for a current diagnosis. Participants completed the Childhood Trauma Questionnaire (CTQ) and the Dissociative Experiences Scale (DES). The International Diagnostics Checklist (IDCL) was administered to diagnose PTSD.
  
  
  RESULTS
  Higher levels of dissociation were observed in patients with drug dependence as compared to patients with mere alcohol dependence (mean DES group A: 9.9+/-8.8; group D: 12.9+/-11.7; group AD: 15.1+/-11.3). However, when severity of potentially traumatic events in childhood, PTSD, age and gender were included in the analysis, the influence of the type of substance abuse did not prove to be statistically significant. The variable most strongly related to dissociative symptoms was severity of potentially traumatic events in childhood, in particular emotional abuse, even after controlling for PTSD and other potential confounders.
  
  
  CONCLUSIONS
  It seems appropriate to screen SUD patients for dissociative symptoms, especially those with a more complex risk profile including (additional) drug abuse, female gender, younger age and most importantly a history of childhood trauma.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf and Center for Interdisciplinary Addiction Research, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany. i.schaefer@uke.uni-hamburg.de
authors.forename: Ingo
authors.initials: I
authors.lastname: Schäfer
authors.forename: Willemien
authors.initials: W
authors.lastname: Langeland
authors.forename: Johanna
authors.initials: J
authors.lastname: Hissbach
authors.forename: Christel
authors.initials: C
authors.lastname: Luedecke
authors.forename: Martin D
authors.initials: MD
authors.lastname: Ohlmeier
authors.forename: Claudia
authors.initials: C
authors.lastname: Chodzinski
authors.forename: Ulrich
authors.initials: U
authors.lastname: Kemper
authors.forename: Peter
authors.initials: P
authors.lastname: Keiper
authors.forename: Dirk
authors.initials: D
authors.lastname: Wedekind
authors.forename: Ursula
authors.initials: U
authors.lastname: Havemann-Reinecke
authors.forename: Sybille
authors.initials: S
authors.lastname: Teunissen
authors.forename: Steffen
authors.initials: S
authors.lastname: Weirich
authors.forename: Martin
authors.initials: M
authors.lastname: Driessen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D002650:Child Abuse, Sexual; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D004213:Dissociative Disorders / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D055815:Young Adult