title: Comorbidity of posttraumatic stress disorder with alcohol dependence among US adults: results from National Epidemiological Survey on Alcohol and Related Conditions.
abstract: BACKGROUND
  Despite the high rates of comorbidity of post-traumatic stress disorder (PTSD) and alcohol dependence (AD) in clinical and epidemiological samples, little is known about the prevalence, clinical presentation, course, risk factors and patterns of treatment-seeking of co-occurring PTSD-AD among the general population.
  
  
  METHODS
  The sample included respondents of the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Weighted means, frequencies and odds ratios (ORs) of sociodemographic correlates, prevalence of psychiatric disorders and rates of treatment-seeking were computed.
  
  
  RESULTS
  In the general population, the lifetime prevalence of PTSD only, AD only and PTSD-AD was 4.83%, 13.66% and 1.59%, respectively. Individuals with comorbid PTSD-AD were more likely than those with PTSD or AD only to have suffered childhood adversities and had higher rates of Axis I and II disorders and suicide attempts. They also met more PTSD diagnostic criteria, had earlier onset of PTSD and were more likely to use drugs and alcohol to relieve their PTSD symptoms than those with PTSD only; they also met more AD diagnostic criteria than those with AD only and had greater disability. Individuals with PTSD-AD had higher rates of treatment seeking for AD than those with AD only, but similar rates than those with PTSD only.
  
  
  CONCLUSIONS
  PTSD-AD is associated with high levels of severity across a broad range of domains even compared with individuals with PTSD or AD only, yet treatment-seeking rates are very low. There is a need to improve treatment access and outcomes for individuals with PTSD-AD.
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY 10032, United States. Electronic address: cb255@columbia.edu.
authors.forename: Carlos
authors.initials: C
authors.lastname: Blanco
authors.forename: Yang
authors.initials: Y
authors.lastname: Xu
authors.forename: Kathleen
authors.initials: K
authors.lastname: Brady
authors.forename: Gabriela
authors.initials: G
authors.lastname: Pérez-Fuentes
authors.forename: Mayumi
authors.initials: M
authors.lastname: Okuda
authors.forename: Shuai
authors.initials: S
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006306:Health Surveys / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol dependence; Comorbidity; NESARC; Post-traumatic stress disorder (PTSD); Substance use disorders