title: Posttraumatic stress disorder's role in integrated substance dependence and depression treatment outcomes.
abstract: Posttraumatic stress disorder (PTSD) frequently co-occurs with depression and substance use disorder (SUD). This study investigates the impact of PTSD diagnosis on treatment outcomes of 178 veterans treated for depression and SUD, with Integrated Cognitive-Behavioral Therapy (ICBT) or 12-Step Facilitation Therapy (TSF). Percentage days abstinent (PDA) and Hamilton Depression Rating Scale total score (HDRS total) trajectories were created. PDA was similar through initial follow-up; however, by 18 months, ICBT participants without PTSD had better PDA (M = 91%) than those without PTSD in TSF (M = 76%) and those with PTSD in either group (M = 75%-77%). Across time, participants with PTSD had higher depression levels than those without PTSD but benefited similarly from treatment (main effect, p < .004). Both conditions demonstrated reductions in average HDRS at 18 months (M = 17%-29%). Findings highlight the need to assess for PTSD and to investigate how to treat concomitant SUD, depression, and PTSD.
authors.affiliation: VA San Diego Healthcare System and University of California, San Diego, San Diego, CA 92161, USA.
authors.forename: Sonya B
authors.initials: SB
authors.lastname: Norman
authors.forename: Susan R
authors.initials: SR
authors.lastname: Tate
authors.forename: Kendall C
authors.initials: KC
authors.lastname: Wilkins
authors.forename: Kevin
authors.initials: K
authors.lastname: Cummins
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Brown
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D019033:Delivery of Health Care, Integrated / Q000379:methods; D003866:Depressive Disorder / Q000150:complications* / Q000628:therapy; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000628:therapy; D019966:Substance-Related Disorders / Q000150:complications / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014728:Veterans / Q000523:psychology