Rates and predictors of psychotherapy receipt among U.S. veterans with comorbid posttraumatic stress disorder and substance use disorders
Introduction: Veterans with comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD) have complex needs and often do not receive adequate mental health treatment. The purpose of this study was to examine rates and predictors of PTSD-only, SUD-only, or PTSD and SUD psychotherapy...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | Drug and Alcohol Dependence Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S277272462100010X |
| _version_ | 1819349463515267072 |
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| author | Rebecca Grekin, Ph.D Kipling M. Bohnert, Ph.D Peter P. Grau, Ph.D Dara Ganoczy, MPH Rebecca K. Sripada, Ph.D |
| author_facet | Rebecca Grekin, Ph.D Kipling M. Bohnert, Ph.D Peter P. Grau, Ph.D Dara Ganoczy, MPH Rebecca K. Sripada, Ph.D |
| author_sort | Rebecca Grekin, Ph.D |
| collection | DOAJ |
| description | Introduction: Veterans with comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD) have complex needs and often do not receive adequate mental health treatment. The purpose of this study was to examine rates and predictors of PTSD-only, SUD-only, or PTSD and SUD psychotherapy receipt among newly diagnosed Veterans with PTSD and SUD. Design and setting: An administrative dataset including Veterans Health Administration (VHA) users. Participants: The sample comprised 32,779 United States Veterans with a new PTSD and a new SUD diagnosis in fiscal year 2015. Measurement: Multinomial logistic regression was used to identify predictors of receipt of any and adequate psychotherapy for PTSD, SUD, or PTSD and SUD across settings. Binomial logistic regression was used to identify predictors of PTSD psychotherapy among those who received any psychotherapy. Findings: A total of 13,824 (42.17%) Veterans in this sample received any PTSD- or SUD-related therapy in the year following diagnosis. Low rates of veterans received an adequate dose of PTSD-related psychotherapy (6.58%), SUD-related psychotherapy (7.72%), or both PTSD and SUD-related psychotherapy (<1%) In adjusted models, older age, service-connected disability, and psychiatric comorbidities were associated with decreased odds of treatment. Specific types of SUDs, including alcohol, cocaine, and opioid use disorders, along with receipt of diagnosis in a PTSD or SUD clinic, were associated with increased odds of treatment. Conclusions: Low rates of PTSD and SUD related psychotherapy highlight a need to better engage and retain Veterans with these disorders in care. Predictors of decreased treatment utilization, such as older age, service connection, and bipolar and major depressive disorders, may inform efforts by the VHA to further target and engage Veterans with indicated treatments. |
| first_indexed | 2024-12-24T19:00:55Z |
| format | Article |
| id | doaj.art-724448eba9b5455098f02d2e7cac7f47 |
| institution | Directory Open Access Journal |
| issn | 2772-7246 |
| language | English |
| last_indexed | 2024-12-24T19:00:55Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Drug and Alcohol Dependence Reports |
| spelling | doaj.art-724448eba9b5455098f02d2e7cac7f472022-12-21T16:43:13ZengElsevierDrug and Alcohol Dependence Reports2772-72462021-12-011100010Rates and predictors of psychotherapy receipt among U.S. veterans with comorbid posttraumatic stress disorder and substance use disordersRebecca Grekin, Ph.D0Kipling M. Bohnert, Ph.D1Peter P. Grau, Ph.D2Dara Ganoczy, MPH3Rebecca K. Sripada, Ph.D4VA Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), 2800 Plymouth Road, Bldg 16, Ann Arbor, MI 48109, United States; Great Lakes Perinatal Wellness, Ann Arbor, MI 48105, United States; Department of Psychological and Brain Sciences, University of Iowa, United StatesDepartment of Epidemiology and Biostatistics, Michigan State University, United StatesVA Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), 2800 Plymouth Road, Bldg 16, Ann Arbor, MI 48109, United States; VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; Department of Psychiatry, University of Michigan Medical School, United StatesVeterans Affairs Center for Clinical Management Research, Health Services Research and Development, Ann Arbor Michigan, United StatesVA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; Department of Psychiatry, University of Michigan Medical School, United States; Veterans Affairs Center for Clinical Management Research, Health Services Research and Development, Ann Arbor Michigan, United States; Corresponding author at: Serious Mental Illness Treatment Resource and Evaluation Center, 2800 Plymouth Road, 016, Ann Arbor, MI 48109, United States.Introduction: Veterans with comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD) have complex needs and often do not receive adequate mental health treatment. The purpose of this study was to examine rates and predictors of PTSD-only, SUD-only, or PTSD and SUD psychotherapy receipt among newly diagnosed Veterans with PTSD and SUD. Design and setting: An administrative dataset including Veterans Health Administration (VHA) users. Participants: The sample comprised 32,779 United States Veterans with a new PTSD and a new SUD diagnosis in fiscal year 2015. Measurement: Multinomial logistic regression was used to identify predictors of receipt of any and adequate psychotherapy for PTSD, SUD, or PTSD and SUD across settings. Binomial logistic regression was used to identify predictors of PTSD psychotherapy among those who received any psychotherapy. Findings: A total of 13,824 (42.17%) Veterans in this sample received any PTSD- or SUD-related therapy in the year following diagnosis. Low rates of veterans received an adequate dose of PTSD-related psychotherapy (6.58%), SUD-related psychotherapy (7.72%), or both PTSD and SUD-related psychotherapy (<1%) In adjusted models, older age, service-connected disability, and psychiatric comorbidities were associated with decreased odds of treatment. Specific types of SUDs, including alcohol, cocaine, and opioid use disorders, along with receipt of diagnosis in a PTSD or SUD clinic, were associated with increased odds of treatment. Conclusions: Low rates of PTSD and SUD related psychotherapy highlight a need to better engage and retain Veterans with these disorders in care. Predictors of decreased treatment utilization, such as older age, service connection, and bipolar and major depressive disorders, may inform efforts by the VHA to further target and engage Veterans with indicated treatments.http://www.sciencedirect.com/science/article/pii/S277272462100010XPosttraumatic stress disorderSubstance use disorderVeteransPsychotherapy receiptPTSD-SUD comorbidity |
| spellingShingle | Rebecca Grekin, Ph.D Kipling M. Bohnert, Ph.D Peter P. Grau, Ph.D Dara Ganoczy, MPH Rebecca K. Sripada, Ph.D Rates and predictors of psychotherapy receipt among U.S. veterans with comorbid posttraumatic stress disorder and substance use disorders Drug and Alcohol Dependence Reports Posttraumatic stress disorder Substance use disorder Veterans Psychotherapy receipt PTSD-SUD comorbidity |
| title | Rates and predictors of psychotherapy receipt among U.S. veterans with comorbid posttraumatic stress disorder and substance use disorders |
| title_full | Rates and predictors of psychotherapy receipt among U.S. veterans with comorbid posttraumatic stress disorder and substance use disorders |
| title_fullStr | Rates and predictors of psychotherapy receipt among U.S. veterans with comorbid posttraumatic stress disorder and substance use disorders |
| title_full_unstemmed | Rates and predictors of psychotherapy receipt among U.S. veterans with comorbid posttraumatic stress disorder and substance use disorders |
| title_short | Rates and predictors of psychotherapy receipt among U.S. veterans with comorbid posttraumatic stress disorder and substance use disorders |
| title_sort | rates and predictors of psychotherapy receipt among u s veterans with comorbid posttraumatic stress disorder and substance use disorders |
| topic | Posttraumatic stress disorder Substance use disorder Veterans Psychotherapy receipt PTSD-SUD comorbidity |
| url | http://www.sciencedirect.com/science/article/pii/S277272462100010X |
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